ADAM MICHAEL ELLIS MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036149586

License Status

INACTIVE

Business

Title

First Name

ADAM

Middle

MICHAEL

Last Name

ELLIS

Business Name

ADAM MICHAEL ELLIS MD

Original Issue Date

06/07/2019

Effective Date

06/07/2019

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60654

County

COOK

Ever Disciplined

LastModifiedDate

05/12/2020