CHAD L CLARK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

NOT RENEWED

Business

First Name

CHAD

Middle

Last Name

CLARK

Business Name

CHAD L CLARK

Original Issue Date

07/22/1999

Effective Date

07/22/1999

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60631

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006