CAMELLIA P CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036073990

License Status

NOT RENEWED

Business

First Name

CAMELLIA P

Last Name

CLARK

Suffix

Business Name

CAMELLIA P CLARK MD

Original Issue Date

10/20/1986

Effective Date

10/20/1986

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006