FELICIA ANNE CLARK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****58

License Status

ACTIVE

Business

First Name

FELICIA

Middle

ANNE

Last Name

CLARK

Business Name

FELICIA ANNE CLARK

Original Issue Date

01/25/2021

Effective Date

01/06/2026

Expiration Date

03/01/2028

City

PEORIA

State

Zip

61606

County

PEORIA

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/06/2026