NATHANIEL EDWIN CLARK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003278

License Status

ACTIVE

Business

First Name

NATHANIEL

Middle

EDWIN

Last Name

CLARK

Business Name

NATHANIEL EDWIN CLARK

Original Issue Date

08/14/2008

Effective Date

02/03/2026

Expiration Date

03/01/2028

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

02/03/2026