JONATHAN D ELLEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125021758

License Status

EXPIRED

Business

First Name

JONATHAN

Middle

Last Name

ELLEN

Suffix

Business Name

JONATHAN D ELLEN MD

Original Issue Date

10/22/1987

Effective Date

10/22/1987

Expiration Date

08/14/1990

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006