EDWARD C CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

NOT RENEWED

Business

First Name

EDWARD C

Last Name

CLARK

Suffix

Business Name

EDWARD C CLARK MD

Original Issue Date

04/22/1985

Effective Date

04/22/1985

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006