MATTHEW PATRICK ELLISON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

NOT RENEWED

Business

Title

DDS

First Name

MATTHEW

Middle

PATRICK

Last Name

ELLISON

Business Name

MATTHEW PATRICK ELLISON DDS

Original Issue Date

10/06/2015

Effective Date

10/06/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60604

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018