PAUL DAVID FULLING MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

ACTIVE

Business

First Name

PAUL

Middle

DAVID

Last Name

FULLING

Suffix

Business Name

PAUL DAVID FULLING MD

Original Issue Date

04/12/2002

Effective Date

05/25/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/25/2023