MARCO FREDRICK ELLIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

ACTIVE

Business

First Name

MARCO

Middle

FREDRICK

Last Name

ELLIS

Suffix

Business Name

MARCO FREDRICK ELLIS MD

Original Issue Date

07/24/2008

Effective Date

06/21/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/21/2023