ROBERT RYAN CLARK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****85

License Status

NOT RENEWED

Business

First Name

ROBERT RYAN

Last Name

CLARK

Suffix

DDS

Business Name

ROBERT RYAN CLARK DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1996

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005