MELISSA GAYLE CLARK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002601

License Status

ACTIVE

Business

First Name

MELISSA

Middle

GAYLE

Last Name

CLARK

Business Name

MELISSA GAYLE CLARK

Original Issue Date

09/29/2005

Effective Date

12/03/2025

Expiration Date

03/01/2028

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Ever Disciplined

LastModifiedDate

12/03/2025