PATRICK KEVIN ENNIS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064842

License Status

CANCELLED

Business

Title

First Name

PATRICK

Middle

KEVIN

Last Name

ENNIS

Business Name

PATRICK KEVIN ENNIS MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2017

City

CHICAGO

State

Zip

60641

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/30/2014