BENJAMIN ELLISON COLLIE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068420

License Status

EXPIRED

Business

Title

First Name

BENJAMIN

Middle

ELLISON

Last Name

COLLIE

Business Name

BENJAMIN ELLISON COLLIE MD

Original Issue Date

06/27/2016

Effective Date

06/27/2016

Expiration Date

06/26/2019

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/02/2019