TRACY C FULLER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004406

License Status

ACTIVE

Business

First Name

TRACY

Middle

Last Name

FULLER

Business Name

TRACY C FULLER

Original Issue Date

08/16/2012

Effective Date

01/22/2026

Expiration Date

03/01/2028

City

GLENVIEW

State

Zip

60026

County

COOK

Ever Disciplined

LastModifiedDate

01/22/2026