ELLEN THERESA MCDERMOTT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

Title

First Name

ELLEN

Middle

THERESA

Last Name

MCDERMOTT

Business Name

ELLEN THERESA MCDERMOTT MD

Original Issue Date

05/28/2008

Effective Date

07/27/2011

Expiration Date

07/31/2014

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014