DAVID J CLARK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042500

License Status

EXPIRED

Business

First Name

DAVID

Middle

Last Name

CLARK

Suffix

Business Name

DAVID J CLARK MD

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2006

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

09/22/2006