ANDREA BETH FULCOMER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004757

License Status

ACTIVE

Business

First Name

ANDREA

Middle

BETH

Last Name

FULCOMER

Business Name

ANDREA BETH FULCOMER

Original Issue Date

07/23/2013

Effective Date

02/14/2024

Expiration Date

03/01/2026

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

12/03/2025