RANDALL BRUCE CLARK II DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036149524

License Status

NOT RENEWED

Business

Title

First Name

RANDALL

Middle

BRUCE

Last Name

CLARK II

Business Name

RANDALL BRUCE CLARK II DO

Original Issue Date

06/03/2019

Effective Date

09/23/2020

Expiration Date

07/31/2023

City

COOKEVILLE

State

Zip

38501

County

PUTNAM

Ever Disciplined

LastModifiedDate

11/30/2023