MICHELLE JOY CLARK-FORSTING MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001005

License Status

CANCELLED

Business

Title

First Name

MICHELLE

Middle

JOY

Last Name

CLARK-FORSTING

Business Name

MICHELLE JOY CLARK-FORSTING MD

Original Issue Date

08/25/2014

Effective Date

08/25/2014

Expiration Date

09/24/2014

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/13/2015