BEVERLY C CLARK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000029

License Status

NOT RENEWED

Business

First Name

BEVERLY C

Last Name

CLARK

Business Name

BEVERLY C CLARK

Original Issue Date

11/05/1980

Effective Date

11/05/1980

Expiration Date

03/01/1990

City

DELAVAN

State

Zip

61734

County

TAZEWELL

Ever Disciplined

LastModifiedDate

09/26/2006