ERIC BRADLEY FULLER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

ACTIVE

Business

Title

First Name

ERIC

Middle

BRADLEY

Last Name

FULLER

Business Name

ERIC BRADLEY FULLER MD

Original Issue Date

04/22/2013

Effective Date

05/06/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/06/2023