JENNIFER ELIZABETH CLARK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****06

License Status

ACTIVE

Business

First Name

JENNIFER

Middle

ELIZABETH

Last Name

CLARK

Business Name

JENNIFER ELIZABETH CLARK

Original Issue Date

11/15/2016

Effective Date

12/05/2025

Expiration Date

03/01/2028

City

NEW LENOX

State

Zip

60451

County

WILL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/05/2025