ALEX EDWARD FULTZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

Title

First Name

ALEX

Middle

EDWARD

Last Name

FULTZ

Business Name

ALEX EDWARD FULTZ MD

Original Issue Date

08/05/2022

Effective Date

08/05/2022

Expiration Date

07/31/2023

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023