MICHALA EILEEN CLARK DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125086108

License Status

ACTIVE

Business

Title

First Name

MICHALA

Middle

EILEEN

Last Name

CLARK

Business Name

MICHALA EILEEN CLARK DO

Original Issue Date

07/01/2025

Effective Date

07/01/2025

Expiration Date

06/30/2028

City

PEORIA

State

Zip

61602

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/30/2025