KELLY M ELLESON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066446

License Status

CANCELLED

Business

Title

First Name

KELLY

Middle

Last Name

ELLESON

Business Name

KELLY M ELLESON MD

Original Issue Date

06/23/2018

Effective Date

06/23/2018

Expiration Date

06/22/2020

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

02/05/2018