SHAWNESE GILPIN CLARK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073399

License Status

EXPIRED

Business

Title

First Name

SHAWNESE

Middle

GILPIN

Last Name

CLARK

Business Name

SHAWNESE GILPIN CLARK MD

Original Issue Date

07/05/2018

Effective Date

07/05/2018

Expiration Date

07/04/2021

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

10/11/2022