MICHAEL J CLARK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125020894

License Status

EXPIRED

Business

First Name

MICHAEL J

Last Name

CLARK

Suffix

Business Name

MICHAEL J CLARK MD

Original Issue Date

05/18/1987

Effective Date

05/18/1987

Expiration Date

06/23/1990

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006