MA BELEN S CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104581

License Status

NOT RENEWED

Business

First Name

MA BELEN

Middle

Last Name

CLARK

Suffix

Business Name

MA BELEN S CLARK MD

Original Issue Date

04/24/2001

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

11/06/2008