BRIAN C CLARK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

ACTIVE

Business

Title

First Name

BRIAN

Middle

Last Name

CLARK

Business Name

BRIAN C CLARK MD

Original Issue Date

04/19/2019

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023