ELYSE ANNE SHAW ELLIS MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049175861

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

04/25/2007

Effective Date

06/12/2009

Expiration Date

03/31/2010

City

KIRKWOOD

State

Zip

63122

Ever Disciplined

LastModifiedDate

05/04/2010