JEFFREY D CLARK Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070012592

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

Last Name

CLARK

Business Name

JEFFREY D CLARK

Original Issue Date

08/23/2001

Effective Date

07/30/2010

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

01/16/2013