ISAAC ELLISON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****51

License Status

NOT RENEWED

Business

First Name

ISAAC

Last Name

ELLISON

Business Name

ISAAC ELLISON

Original Issue Date

07/02/2022

Effective Date

07/02/2022

Expiration Date

09/30/2024

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025