CLARK ELON SMITH Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001652

License Status

EXPIRED

Business

First Name

CLARK

Middle

ELON

Last Name

SMITH

Business Name

CLARK ELON SMITH

Original Issue Date

08/15/2007

Effective Date

08/15/2007

Expiration Date

05/30/2010

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

06/02/2010