NONA P FULK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

First Name

NONA

Middle

Last Name

FULK

Suffix

Business Name

NONA P FULK MD

Original Issue Date

05/16/2005

Effective Date

06/22/2011

Expiration Date

07/31/2014

City

CARMI

State

Zip

62821

County

WHITE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020