CHAD L CLARK - Medical Doctor License in Illinois | # 125036874

CHAD L CLARK

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036874

License Status

EXPIRED

Business

N

First Name

CHAD

Middle

L

Last Name

CLARK

Business Name

CHAD L CLARK

Original Issue Date

06/20/1997

Effective Date

06/20/1997

Expiration Date

06/22/2000

State

IL

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006