DONALD L CLARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

NOT RENEWED

Business

First Name

DONALD

Middle

Last Name

CLARK

Suffix

Business Name

DONALD L CLARK MD

Original Issue Date

08/09/2005

Effective Date

06/02/2014

Expiration Date

07/31/2017

City

DAYTON

State

Zip

45435

County

OHIO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020