KASANDRIA CLARK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125080964

License Status

CANCELLED

Business

Title

First Name

KASANDRIA

Last Name

CLARK

Business Name

KASANDRIA CLARK MD

Original Issue Date

06/25/2022

Effective Date

06/25/2022

Expiration Date

06/24/2025

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

10/23/2024