JERROLD A CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036065410

License Status

NOT RENEWED

Business

First Name

JERROLD

Middle

Last Name

CLARK

Suffix

Business Name

JERROLD A CLARK MD

Original Issue Date

10/06/1982

Effective Date

10/06/1982

Expiration Date

07/31/1984

City

EVANSVILLE

State

Zip

47715

Ever Disciplined

LastModifiedDate

10/11/2007