RICHARD R CLARK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

ACTIVE

Business

First Name

RICHARD R

Last Name

CLARK

Suffix

Business Name

RICHARD R CLARK MD

Original Issue Date

12/19/2018

Effective Date

05/07/2023

Expiration Date

07/31/2026

City

GRAYSLAKE

State

Zip

60030

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/07/2023