SAMUEL SMITH CLARK MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036041129

License Status

INACTIVE

Business

First Name

SAMUEL SMITH

Last Name

CLARK

Suffix

Business Name

SAMUEL SMITH CLARK MD

Original Issue Date

07/07/1967

Effective Date

07/07/1967

Expiration Date

07/31/1996

City

FAYSTON

State

Zip

05673

County

VERMONT

Ever Disciplined

LastModifiedDate

09/20/2006