HOLLIS J CLARK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005391

License Status

NOT RENEWED

Business

First Name

HOLLIS

Middle

Last Name

CLARK

Business Name

HOLLIS J CLARK

Original Issue Date

01/30/2015

Effective Date

03/01/2022

Expiration Date

03/01/2024

City

MURPHYSBORO

State

Zip

62966

County

JACKSON

Ever Disciplined

LastModifiedDate

02/05/2025