CLARENCE RICHARD HART MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036043259

License Status

NOT RENEWED

Business

First Name

CLARENCE RICHARD

Last Name

HART

Suffix

Business Name

CLARENCE RICHARD HART MD

Original Issue Date

04/14/1970

Effective Date

04/14/1970

Expiration Date

07/31/1993

City

LAKE GENEVA

State

Zip

53147

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/03/2006