ELLEN L PRATT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

NOT RENEWED

Business

Title

First Name

ELLEN

Middle

Last Name

PRATT

Business Name

ELLEN L PRATT MD

Original Issue Date

05/16/2003

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020