BENJAMIN DAVID ELLISON DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125086414

License Status

ACTIVE

Business

Title

First Name

BENJAMIN

Middle

DAVID

Last Name

ELLISON

Business Name

BENJAMIN DAVID ELLISON DO

Original Issue Date

07/01/2025

Effective Date

07/01/2025

Expiration Date

06/30/2028

City

OLYMPIA FIELDS

State

Zip

60461

Specialty/Qualifier

Urological Surgery

Ever Disciplined

LastModifiedDate

06/08/2025