ELLEN CLAIR BOUAZIZI MD - Medical Doctor License in Illinois | # 125077482

ELLEN CLAIR BOUAZIZI MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077482

License Status

EXPIRED

Business

N

Title

MD

First Name

ELLEN

Middle

CLAIR

Last Name

BOUAZIZI

Business Name

ELLEN CLAIR BOUAZIZI MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

State

IL

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

N

LastModifiedDate

10/30/2024