KILMENY CLARK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****55

License Status

ACTIVE

Business

First Name

KILMENY

Last Name

CLARK

Business Name

KILMENY CLARK

Original Issue Date

04/21/2021

Effective Date

02/18/2026

Expiration Date

03/01/2028

City

DECATUR

State

Zip

62521

County

MACON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/18/2026