DAVID MICHAEL CLARK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019026683

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

MICHAEL

Last Name

CLARK

Suffix

DDS

Business Name

DAVID MICHAEL CLARK DDS

Original Issue Date

04/18/2005

Effective Date

06/29/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

02/08/2016