STANLEY E CLARK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125019484

License Status

EXPIRED

Business

First Name

STANLEY E

Last Name

CLARK

Suffix

Business Name

STANLEY E CLARK MD

Original Issue Date

06/18/1986

Effective Date

06/18/1986

Expiration Date

06/22/1989

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006