RODERICK FULTON HUME JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

First Name

RODERICK

Middle

FULTON

Last Name

HUME

Suffix

JR MD

Business Name

RODERICK FULTON HUME JR MD

Original Issue Date

08/14/2001

Effective Date

08/14/2001

Expiration Date

07/31/2005

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006