CLARK RICHARD MCDANIEL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

CANCELLED

Business

First Name

CLARK RICHARD

Last Name

MCDANIEL

Suffix

Business Name

CLARK RICHARD MCDANIEL MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

DIXON

State

Zip

61021

County

LEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006