ELLEN L POLISKY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

ELLEN L

Last Name

POLISKY

Suffix

Business Name

ELLEN L POLISKY MD

Original Issue Date

08/15/2005

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

SKOKIE

State

Zip

60076

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021