WAYNE ALLEN FULLER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036170281

License Status

ACTIVE

Business

Title

First Name

WAYNE

Middle

ALLEN

Last Name

FULLER

Business Name

WAYNE ALLEN FULLER MD

Original Issue Date

05/15/2024

Effective Date

05/15/2024

Expiration Date

07/31/2026

City

MUSKEGON

State

Zip

49445

Ever Disciplined

LastModifiedDate

05/15/2024