JONI MARIE CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

First Name

JONI MARIE

Last Name

CLARK

Suffix

Business Name

JONI MARIE CLARK MD

Original Issue Date

12/12/1996

Effective Date

12/12/1996

Expiration Date

07/31/2008

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020