ENRIQUE FERNANDO ELLI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

First Name

ENRIQUE

Middle

FERNANDO

Last Name

ELLI

Suffix

Business Name

ENRIQUE FERNANDO ELLI MD

Original Issue Date

05/06/2009

Effective Date

05/12/2014

Expiration Date

07/31/2017

City

GLENCOE

State

Zip

60022

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020