SAMUEL F ELLISON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125014507

License Status

EXPIRED

Business

First Name

SAMUEL F

Last Name

ELLISON

Suffix

Business Name

SAMUEL F ELLISON MD

Original Issue Date

06/25/1982

Effective Date

06/25/1982

Expiration Date

07/01/1984

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006