JOHN DALE FULK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****77

License Status

ACTIVE

Business

First Name

JOHN

Middle

DALE

Last Name

FULK

Business Name

JOHN DALE FULK

Original Issue Date

03/13/2001

Effective Date

01/05/2026

Expiration Date

03/01/2028

City

NORMAL

State

Zip

61761

County

MCLEAN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/05/2026