CINDY M FORTADO-CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

First Name

CINDY M

Last Name

FORTADO-CLARK

Suffix

Business Name

CINDY M FORTADO-CLARK MD

Original Issue Date

05/06/1988

Effective Date

05/06/1988

Expiration Date

07/31/1999

City

EAST ALTON

State

Zip

62024

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020