DOUGLAS L FULK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

ACTIVE

Business

First Name

DOUGLAS

Middle

Last Name

FULK

Suffix

Business Name

DOUGLAS L FULK MD

Original Issue Date

01/28/1998

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62903

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2023