ANDREA MARTHA ELLIS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046543

License Status

EXPIRED

Business

First Name

ANDREA

Middle

MARTHA

Last Name

ELLIS

Suffix

Business Name

ANDREA MARTHA ELLIS MD

Original Issue Date

07/01/2003

Effective Date

07/01/2003

Expiration Date

06/30/2006

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006