ANN L MELLOTT Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036096502

License Status

NOT RENEWED

Business

First Name

ANN L

Last Name

MELLOTT

Business Name

ANN L MELLOTT

Original Issue Date

08/20/1997

Effective Date

05/13/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017