KENNETH KIRK ELLIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

First Name

KENNETH KIRK

Last Name

ELLIS

Suffix

Business Name

KENNETH KIRK ELLIS MD

Original Issue Date

07/26/1991

Effective Date

07/26/1991

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006