LAURIE C CLARK DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036130673

License Status

NOT RENEWED

Business

Title

First Name

LAURIE

Middle

Last Name

CLARK

Business Name

LAURIE C CLARK DO

Original Issue Date

06/28/2012

Effective Date

04/16/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60623

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017