SUSAN B FULLERTON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

First Name

SUSAN B

Last Name

FULLERTON

Suffix

Business Name

SUSAN B FULLERTON MD

Original Issue Date

04/24/1984

Effective Date

04/24/1984

Expiration Date

07/31/1996

City

NAPERVILLE

State

Zip

60563

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006