WALTER S JELLISH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

WALTER S

Last Name

JELLISH

Suffix

Business Name

WALTER S JELLISH MD

Original Issue Date

06/12/1991

Effective Date

05/15/2017

Expiration Date

09/30/2020

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021