SUE ELLEN CLARK MD - Medical Doctor License in Illinois | # 036093117

SUE ELLEN CLARK MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036093117

License Status

NOT RENEWED

Business

N

First Name

SUE ELLEN

Last Name

CLARK

Suffix

MD

Business Name

SUE ELLEN CLARK MD

Original Issue Date

06/08/1996

Effective Date

10/01/2020

Expiration Date

07/31/2023

State

IL

Ever Disciplined

N

LastModifiedDate

11/30/2023