ELYSE ANNE SHAW ELLIS MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****22

NOT RENEWED

N

MD

ELYSE

ANNE

SHAW ELLIS

ELYSE ANNE SHAW ELLIS MD

06/19/2019

10/08/2020

07/31/2023

KIRKWOOD

MO

63122

PRACTITIONER

II III IV V

N

11/30/2023