BRIAN JOSEPH CLARK MD - Medical Doctor License in Illinois | # 125058586

BRIAN JOSEPH CLARK MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058586

License Status

CANCELLED

Business

N

Title

MD

First Name

BRIAN

Middle

JOSEPH

Last Name

CLARK

Business Name

BRIAN JOSEPH CLARK MD

Original Issue Date

06/23/2010

Effective Date

06/23/2010

Expiration Date

06/22/2013

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

04/06/2010