RICHARD LEROY ELLIS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125026224

License Status

EXPIRED

Business

First Name

RICHARD LEROY

Last Name

ELLIS

Suffix

Business Name

RICHARD LEROY ELLIS MD

Original Issue Date

04/22/1991

Effective Date

04/22/1991

Expiration Date

06/25/1994

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006