MICHAEL ISAAC ELLENBOGEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036134546

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

ISAAC

Last Name

ELLENBOGEN

Business Name

MICHAEL ISAAC ELLENBOGEN MD

Original Issue Date

02/05/2014

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

BALTIMORE

State

Zip

21287

Ever Disciplined

LastModifiedDate

01/14/2021