ELLIS DONALD JOHNSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

CANCELLED

Business

First Name

ELLIS DONALD

Last Name

JOHNSON

Suffix

Business Name

ELLIS DONALD JOHNSON MD

Original Issue Date

01/01/1997

Effective Date

06/24/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011