PATRICK JOHN CLARK DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****18

License Status

ACTIVE

Business

Title

DDS

First Name

PATRICK

Middle

JOHN

Last Name

CLARK

Business Name

PATRICK JOHN CLARK DDS

Original Issue Date

08/28/2023

Effective Date

06/12/2024

Expiration Date

09/30/2027

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/12/2024