CLARK CHARLES SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036124878

License Status

NOT RENEWED

Business

Title

First Name

CLARK

Middle

CHARLES

Last Name

SMITH

Business Name

CLARK CHARLES SMITH MD

Original Issue Date

01/25/2010

Effective Date

01/25/2010

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011