RONALD W FULLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

First Name

RONALD

Middle

Last Name

FULLER

Suffix

Business Name

RONALD W FULLER MD

Original Issue Date

11/16/2011

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

SILVIS

State

Zip

61282

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021