KYLE R CLARK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007488

License Status

ACTIVE

Business

First Name

KYLE

Middle

Last Name

CLARK

Business Name

KYLE R CLARK

Original Issue Date

01/10/2020

Effective Date

02/08/2026

Expiration Date

03/01/2028

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

02/08/2026