BIANCA C CLARK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****69

License Status

NOT RENEWED

Business

Title

DDS

First Name

BIANCA

Middle

Last Name

CLARK

Business Name

BIANCA C CLARK DDS

Original Issue Date

08/06/2015

Effective Date

08/06/2015

Expiration Date

09/30/2018

City

NEW YORK

State

Zip

10005

County

NEW YORK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/31/2018