KEVIN SHANE CLARK - Physician Assistant License in Illinois | # 085003431

KEVIN SHANE CLARK

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003431

License Status

NOT RENEWED

Business

N

First Name

KEVIN SHANE

Last Name

CLARK

Business Name

KEVIN SHANE CLARK

Original Issue Date

02/09/2009

Effective Date

02/23/2016

Expiration Date

03/01/2018

State

IL

Ever Disciplined

N

LastModifiedDate

05/10/2018