KASANDRIA CLARK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

ACTIVE

Business

Title

First Name

KASANDRIA

Last Name

CLARK

Business Name

KASANDRIA CLARK MD

Original Issue Date

10/23/2024

Effective Date

10/23/2024

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/23/2024