ELLEN S WALRAVEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125015902

License Status

EXPIRED

Business

First Name

ELLEN

Middle

Last Name

WALRAVEN

Suffix

Business Name

ELLEN S WALRAVEN MD

Original Issue Date

06/15/1983

Effective Date

06/15/1983

Expiration Date

07/01/1985

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006