FREDRICK ELLYIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036059538

License Status

NOT RENEWED

Business

First Name

FREDRICK

Last Name

ELLYIN

Suffix

Business Name

FREDRICK ELLYIN MD

Original Issue Date

10/11/1979

Effective Date

06/12/2017

Expiration Date

09/30/2020

City

SKOKIE

State

Zip

60076

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021