ROBERT RYAN CLARK DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000292

License Status

INACTIVE

Business

First Name

ROBERT RYAN

Last Name

CLARK

Suffix

DDS

Business Name

ROBERT RYAN CLARK DDS

Original Issue Date

08/09/1991

Effective Date

08/09/1991

Expiration Date

09/30/1996

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

LastModifiedDate

10/13/2005