MELISSA A CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

First Name

MELISSA

Middle

Last Name

CLARK

Suffix

Business Name

MELISSA A CLARK MD

Original Issue Date

12/11/2001

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60659

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011