JAMIE LYNN ELLIS-WITTENHAGEN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064533

License Status

CANCELLED

Business

Title

First Name

JAMIE

Middle

LYNN

Last Name

ELLIS-WITTENHAGEN

Business Name

JAMIE LYNN ELLIS-WITTENHAGEN DO

Original Issue Date

06/25/2014

Effective Date

06/25/2014

Expiration Date

06/24/2017

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/14/2014