ALETA VIVIENNE CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036051208

License Status

NOT RENEWED

Business

First Name

ALETA VIVIENNE

Last Name

CLARK

Suffix

Business Name

ALETA VIVIENNE CLARK MD

Original Issue Date

07/10/1975

Effective Date

06/23/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017