ELLEN J DEHM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

ELLEN J

Last Name

DEHM

Suffix

Business Name

ELLEN J DEHM MD

Original Issue Date

06/25/1993

Effective Date

06/25/1993

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006