ELLYN S LEVINE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

ELLYN S

Last Name

LEVINE

Business Name

ELLYN S LEVINE

Original Issue Date

03/24/1994

Effective Date

03/24/1994

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006