TODD B CLARK Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

ACTIVE

Business

First Name

TODD

Middle

Last Name

CLARK

Business Name

TODD B CLARK

Original Issue Date

01/10/2003

Effective Date

09/02/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/02/2023