CHRISTEN RAY MELLANO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

Title

First Name

CHRISTEN

Middle

RAY

Last Name

MELLANO

Business Name

CHRISTEN RAY MELLANO MD

Original Issue Date

04/11/2013

Effective Date

04/11/2013

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014