CINDY M FORTADO-CLARK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125020207

License Status

EXPIRED

Business

First Name

CINDY M

Last Name

FORTADO-CLARK

Suffix

Business Name

CINDY M FORTADO-CLARK MD

Original Issue Date

08/05/1986

Effective Date

08/05/1986

Expiration Date

07/01/1989

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006