ELOISE-MARIE CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

ELOISE-MARIE

Last Name

CLARK

Suffix

Business Name

ELOISE-MARIE CLARK MD

Original Issue Date

08/22/2000

Effective Date

08/22/2000

Expiration Date

07/31/2005

City

INVERNESS

State

Zip

60067

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006