TONYA F FULLER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

TONYA F

Last Name

FULLER

Business Name

TONYA F FULLER

Original Issue Date

06/23/1992

Effective Date

05/14/2014

Expiration Date

07/31/2017

City

HARVEY

State

Zip

60426

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017