RICHARD LEROY ELLIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

NOT RENEWED

Business

First Name

RICHARD LEROY

Last Name

ELLIS

Suffix

Business Name

RICHARD LEROY ELLIS MD

Original Issue Date

08/20/1997

Effective Date

08/20/1997

Expiration Date

07/31/2002

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/09/2006