ELLEN C OMI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114622

License Status

ACTIVE

Business

First Name

ELLEN

Middle

Last Name

OMI

Suffix

Business Name

ELLEN C OMI MD

Original Issue Date

09/19/2005

Effective Date

06/28/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

06/28/2023