DAVID J CLARK Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017747

License Status

EXPIRED

Business

First Name

DAVID

Middle

Last Name

CLARK

Business Name

DAVID J CLARK

Original Issue Date

01/17/1985

Effective Date

01/17/1985

Expiration Date

01/17/1987

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Cardiology

Ever Disciplined

LastModifiedDate

09/22/2006