ELLEN CHASE VAN MOL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056589

License Status

EXPIRED

Business

Title

First Name

ELLEN

Middle

CHASE

Last Name

VAN MOL

Business Name

ELLEN CHASE VAN MOL MD

Original Issue Date

06/22/2009

Effective Date

06/22/2009

Expiration Date

06/21/2012

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

08/29/2012