AMANDA D ELLIS-PELLETIER DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

ACTIVE

Business

First Name

AMANDA

Middle

Last Name

ELLIS-PELLETIER

Suffix

Business Name

AMANDA D ELLIS-PELLETIER DO

Original Issue Date

05/15/2008

Effective Date

06/09/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/09/2023