STEPHEN GREGORY CLARK DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036144071

License Status

NOT RENEWED

Business

Title

First Name

STEPHEN

Middle

GREGORY

Last Name

CLARK

Business Name

STEPHEN GREGORY CLARK DO

Original Issue Date

08/10/2017

Effective Date

08/10/2017

Expiration Date

09/30/2020

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

01/14/2021