PATRICIA L 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

PATRICIA

Middle

Last Name

CLARK

Suffix

Business Name

PATRICIA L CLARK MD

Original Issue Date

06/19/2006

Effective Date

09/22/2014

Expiration Date

07/31/2017

City

NEW LENOX

State

Zip

60451

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017