KIRBY PAUL CLARK Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

ACTIVE

Business

First Name

KIRBY

Middle

PAUL

Last Name

CLARK

Business Name

KIRBY PAUL CLARK

Original Issue Date

11/09/2017

Effective Date

06/03/2023

Expiration Date

07/31/2026

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/03/2023