NONA P FULK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

ACTIVE

Business

First Name

NONA

Middle

Last Name

FULK

Suffix

Business Name

NONA P FULK MD

Original Issue Date

07/22/1997

Effective Date

07/11/2023

Expiration Date

07/31/2026

City

NORMAL

State

Zip

61761

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2023