ELLEN S WALRAVEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036070554

License Status

NOT RENEWED

Business

First Name

ELLEN

Middle

Last Name

WALRAVEN

Suffix

Business Name

ELLEN S WALRAVEN MD

Original Issue Date

05/21/1985

Effective Date

05/21/1985

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60605

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006