RICK G CLARK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

NOT RENEWED

Business

First Name

RICK G

Last Name

CLARK

Business Name

RICK G CLARK

Original Issue Date

10/20/1995

Effective Date

10/20/1995

Expiration Date

07/31/1996

City

KEWANEE

State

Zip

61443

County

HENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006