KENNETH C CLARK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000162

License Status

NOT RENEWED

Business

First Name

KENNETH

Middle

Last Name

CLARK

Business Name

KENNETH C CLARK

Original Issue Date

04/08/1987

Effective Date

04/08/1987

Expiration Date

04/07/1989

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Advanced General Dentistry

Ever Disciplined

LastModifiedDate

10/12/2005