MACEO RUSSELL ELLISON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036035394

License Status

NOT RENEWED

Business

First Name

MACEO RUSSELL

Last Name

ELLISON

Suffix

Business Name

MACEO RUSSELL ELLISON MD

Original Issue Date

08/20/1958

Effective Date

07/20/2017

Expiration Date

09/30/2020

City

CAROL STREAM

State

Zip

60188

County

DUPAGE

Ever Disciplined

LastModifiedDate

01/14/2021