MARTIN I ELLENBY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125019172

License Status

EXPIRED

Business

First Name

MARTIN I

Last Name

ELLENBY

Suffix

Business Name

MARTIN I ELLENBY MD

Original Issue Date

05/19/1986

Effective Date

05/19/1986

Expiration Date

07/01/1989

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006