PATRICK JOHN CLARK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****67

License Status

NOT RENEWED

Business

Title

DDS

First Name

PATRICK

Middle

JOHN

Last Name

CLARK

Business Name

PATRICK JOHN CLARK DDS

Original Issue Date

07/17/2019

Effective Date

07/17/2019

Expiration Date

01/31/2022

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022