JOSHUA T CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

First Name

JOSHUA

Middle

Last Name

CLARK

Suffix

Business Name

JOSHUA T CLARK MD

Original Issue Date

08/05/2005

Effective Date

08/05/2005

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60634

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008