ANDREA BETH FULCOMER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****19

License Status

ACTIVE

Business

First Name

ANDREA

Middle

BETH

Last Name

FULCOMER

Business Name

ANDREA BETH FULCOMER

Original Issue Date

01/15/2014

Effective Date

02/14/2024

Expiration Date

03/01/2026

City

BRODHEAD

State

Zip

53520

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025