Information as of 10/21/2018

Last Updated by Licensee on 06/25/2018

Lance Robert Fuller - MD
License#: 
Issue Date: 
2007-01083
05/21/2010
License Status: 
Renewal Date:
Active  
03/01/2019  
 Public Action: Yes
 See: Actions-Adverse & Administrative Tab
Licensee General Information
Active License
Reason CodeLicense NumberSubcategoryIssue DateExpire Date
 2007-01083 05/21/2010 
Inactive License
Reason CodeLicense NumberSubcategoryIssue DateExpire Date
 2007-01083 06/28/200711/25/2009
By Request2007-01083 07/06/200511/25/2009
  RTL07/06/200506/28/2007
Active Supervisee
SuperviseeTypeStatusApproval Date
Evans, Eric Eugene PAActive08/01/2018
JEFFREY, BENJAMIN NPActive11/02/2017
North Carolina Hospital Admitting Privileges
Out of State Active/Inactive Licenses
None Reported
Out of Country Active/Inactive Licenses
None Reported