CHAD L CLARK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036100546

License Status

NOT RENEWED

Business

First Name

CHAD

Middle

Last Name

CLARK

Business Name

CHAD L CLARK

Original Issue Date

07/02/1999

Effective Date

07/02/1999

Expiration Date

07/31/2002

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006