ELLIS K NAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

Title

First Name

ELLIS

Middle

Last Name

NAM

Business Name

ELLIS K NAM MD

Original Issue Date

05/21/2002

Effective Date

05/21/2002

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020