CHAD L CLARK Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036874

License Status

EXPIRED

Business

First Name

CHAD

Middle

Last Name

CLARK

Business Name

CHAD L CLARK

Original Issue Date

06/20/1997

Effective Date

06/20/1997

Expiration Date

06/22/2000

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006