THOMAS WILLIAM CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

First Name

THOMAS WILLIAM

Last Name

CLARK

Suffix

Business Name

THOMAS WILLIAM CLARK MD

Original Issue Date

01/01/1997

Effective Date

08/19/2008

Expiration Date

07/31/2011

City

MORTON

State

Zip

61550

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017