NINA MARIE CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

First Name

NINA

Middle

MARIE

Last Name

CLARK

Suffix

Business Name

NINA MARIE CLARK MD

Original Issue Date

01/24/2003

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021