DANA MARIE CLARK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057408

License Status

CANCELLED

Business

Title

First Name

DANA

Middle

MARIE

Last Name

CLARK

Business Name

DANA MARIE CLARK MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2013

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Physical Medicine & Rehabilitation

Ever Disciplined

LastModifiedDate

04/13/2010