CLYDE DONALD MARTIN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000969

License Status

EXPIRED

Business

Title

First Name

CLYDE

Middle

DONALD

Last Name

MARTIN

Business Name

CLYDE DONALD MARTIN MD

Original Issue Date

01/05/2022

Effective Date

01/05/2022

Expiration Date

07/04/2022

City

ROCKFORD

State

Zip

61108

Specialty/Qualifier

Trauma Rotation

Ever Disciplined

LastModifiedDate

10/11/2022