EVAN D ELLIS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

NOT RENEWED

Business

First Name

EVAN

Middle

Last Name

ELLIS

Business Name

EVAN D ELLIS

Original Issue Date

07/18/2008

Effective Date

07/01/2011

Expiration Date

07/31/2014

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014