BRIAN JOSEPH CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036132650

License Status

NOT RENEWED

Business

Title

First Name

BRIAN

Middle

JOSEPH

Last Name

CLARK

Business Name

BRIAN JOSEPH CLARK MD

Original Issue Date

04/25/2013

Effective Date

04/25/2013

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014