ERINN COURTNEY FULLER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003695

License Status

NOT RENEWED

Business

First Name

ERINN

Middle

COURTNEY

Last Name

FULLER

Business Name

ERINN COURTNEY FULLER

Original Issue Date

02/11/2010

Effective Date

03/06/2012

Expiration Date

03/01/2014

City

GARY

State

Zip

46403

County

INDIANA

Ever Disciplined

LastModifiedDate

10/16/2014