KRISTIN ALEXANDRIA ELLIS DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068955

License Status

CANCELLED

Business

Title

First Name

KRISTIN

Middle

ALEXANDRIA

Last Name

ELLIS

Business Name

KRISTIN ALEXANDRIA ELLIS DO

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2019

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Urological Surgery

Ever Disciplined

LastModifiedDate

06/29/2017