KEVIN R CLARK DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022637

License Status

EXPIRED

Business

First Name

KEVIN R

Last Name

CLARK

Suffix

Business Name

KEVIN R CLARK DO

Original Issue Date

06/04/1988

Effective Date

06/04/1988

Expiration Date

07/01/1991

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006