KELLY JAMES CLARK DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019026315

License Status

ACTIVE

Business

First Name

KELLY

Middle

JAMES

Last Name

CLARK

Suffix

DDS

Business Name

KELLY JAMES CLARK DDS

Original Issue Date

11/18/2003

Effective Date

05/04/2024

Expiration Date

09/30/2027

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

05/04/2024