MATTHEW ALAN THEOPHILUS CLARKE MD - Medical Doctor License in New York | # 036110992

MATTHEW ALAN THEOPHILUS CLARKE MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036110992

License Status

INACTIVE

Business

N

First Name

MATTHEW ALAN

Middle

THEOPHILUS

Last Name

CLARKE

Suffix

MD

Business Name

MATTHEW ALAN THEOPHILUS CLARKE MD

Original Issue Date

03/11/2004

Effective Date

03/11/2004

Expiration Date

07/31/2005

State

NY

Ever Disciplined

N

LastModifiedDate

10/09/2006