ELYSE ANNE SHAW ELLIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036149846

License Status

NOT RENEWED

Business

Title

First Name

ELYSE

Middle

ANNE

Last Name

SHAW ELLIS

Business Name

ELYSE ANNE SHAW ELLIS MD

Original Issue Date

06/19/2019

Effective Date

10/08/2020

Expiration Date

07/31/2023

City

KIRKWOOD

State

Zip

63122

Ever Disciplined

LastModifiedDate

11/30/2023