MARIE ELLEN ELLIS DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

ACTIVE

Business

Title

First Name

MARIE

Middle

ELLEN

Last Name

ELLIS

Business Name

MARIE ELLEN ELLIS DO

Original Issue Date

09/18/2021

Effective Date

07/04/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60617

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/04/2023