ANN L MELLOTT Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033184

License Status

EXPIRED

Business

First Name

ANN L

Last Name

MELLOTT

Business Name

ANN L MELLOTT

Original Issue Date

06/08/1995

Effective Date

06/08/1995

Expiration Date

06/19/1998

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006