ANGELA K FULGHAM GARDNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

ANGELA

Middle

Last Name

FULGHAM GARDNER

Suffix

Business Name

ANGELA K FULGHAM GARDNER MD

Original Issue Date

01/30/1998

Effective Date

01/30/1998

Expiration Date

07/31/2002

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006