PETER STEVEN ELLIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

First Name

PETER STEVEN

Last Name

ELLIS

Suffix

Business Name

PETER STEVEN ELLIS MD

Original Issue Date

06/10/1997

Effective Date

06/10/1997

Expiration Date

07/31/1999

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006