DOUGLAS R ELLIS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125021957

License Status

EXPIRED

Business

First Name

DOUGLAS R

Last Name

ELLIS

Suffix

Business Name

DOUGLAS R ELLIS MD

Original Issue Date

05/05/1988

Effective Date

05/05/1988

Expiration Date

07/01/1991

City

DECATUR

State

Zip

62521

County

MACON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006