BRADLEY PHILIP CLARK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019015420

License Status

NOT RENEWED

Business

First Name

BRADLEY PHILIP

Last Name

CLARK

Suffix

DDS

Business Name

BRADLEY PHILIP CLARK DDS

Original Issue Date

03/02/1976

Effective Date

03/02/1976

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

10/12/2005