TODD B CLARK - Medical Doctor License in Illinois | # 125039580

TODD B CLARK

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039580

License Status

EXPIRED

Business

N

First Name

TODD

Middle

B

Last Name

CLARK

Business Name

TODD B CLARK

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2002

State

IL

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006