DAVID L ELLENS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036088924

License Status

NOT RENEWED

Business

First Name

DAVID L

Last Name

ELLENS

Business Name

DAVID L ELLENS

Original Issue Date

07/11/1994

Effective Date

07/21/2020

Expiration Date

07/31/2023

City

TINLEY PARK

State

Zip

60477

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023