ELLEN D WALTHALL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036085696

License Status

NOT RENEWED

Business

First Name

ELLEN D

Last Name

WALTHALL

Suffix

Business Name

ELLEN D WALTHALL MD

Original Issue Date

12/01/1992

Effective Date

12/01/1992

Expiration Date

07/31/1999

City

DESPLAINES

State

Zip

60016

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006