PATRICK JAMES FULLERTON DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

First Name

PATRICK

Middle

JAMES

Last Name

FULLERTON

Suffix

Business Name

PATRICK JAMES FULLERTON DO

Original Issue Date

11/27/2007

Effective Date

11/27/2007

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60659

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008