ROBERT RYAN CLARK DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012839

License Status

INACTIVE

Business

First Name

ROBERT RYAN

Last Name

CLARK

Suffix

DDS

Business Name

ROBERT RYAN CLARK DDS

Original Issue Date

11/23/1965

Effective Date

11/23/1965

Expiration Date

09/30/1996

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/12/2005

Case Number

1990007981

Action

Fine

Discipline Start Date

07/31/1991

Discipline Reason

Continued to utilize an anesthesia technique without the proper permit to do so.