ANDREA MARTHA ELLIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036116155

License Status

ACTIVE

Business

First Name

ANDREA

Middle

MARTHA

Last Name

ELLIS

Suffix

Business Name

ANDREA MARTHA ELLIS MD

Original Issue Date

06/07/2006

Effective Date

07/13/2023

Expiration Date

07/31/2026

City

FORT WAYNE

State

Zip

46814

County

INDIANA

Ever Disciplined

LastModifiedDate

07/13/2023