CHARLOTTE LOUISE ELLENBOGEN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043168

License Status

EXPIRED

Business

First Name

CHARLOTTE

Middle

LOUISE

Last Name

ELLENBOGEN

Suffix

Business Name

CHARLOTTE LOUISE ELLENBOGEN DO

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2004

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006