SHANEISE ELLIS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125079309

License Status

EXPIRED

Business

Title

First Name

SHANEISE

Last Name

ELLIS

Business Name

SHANEISE ELLIS MD

Original Issue Date

06/23/2022

Effective Date

06/23/2022

Expiration Date

06/22/2025

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

11/03/2025