ELLY BUDIMAN-MAK MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046841

License Status

INACTIVE

Business

First Name

ELLY

Last Name

BUDIMAN-MAK

Suffix

Business Name

ELLY BUDIMAN-MAK MD

Original Issue Date

02/07/1973

Effective Date

07/10/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60605

County

COOK

Ever Disciplined

LastModifiedDate

05/31/2023