KATHRYN CLARK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****33

License Status

ACTIVE

Business

First Name

KATHRYN

Last Name

CLARK

Business Name

KATHRYN CLARK

Original Issue Date

03/07/2024

Effective Date

01/18/2026

Expiration Date

03/01/2028

City

ALTON

State

Zip

62002

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/18/2026