MICHELLE JOY CLARK-FORSTING MD - Medical Doctor License in Illinois | # 130001005

MICHELLE JOY CLARK-FORSTING MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001005

License Status

CANCELLED

Business

N

Title

MD

First Name

MICHELLE

Middle

JOY

Last Name

CLARK-FORSTING

Business Name

MICHELLE JOY CLARK-FORSTING MD

Original Issue Date

08/25/2014

Effective Date

08/25/2014

Expiration Date

09/24/2014

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

03/13/2015