RICHARD R CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

RICHARD R

Last Name

CLARK

Suffix

Business Name

RICHARD R CLARK MD

Original Issue Date

05/24/1991

Effective Date

05/24/1991

Expiration Date

07/31/1999

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020