CHRISTINA M CLARK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****96

License Status

NOT RENEWED

Business

First Name

CHRISTINA M

Last Name

CLARK

Business Name

CHRISTINA M CLARK

Original Issue Date

03/05/2002

Effective Date

03/05/2002

Expiration Date

03/01/2006

City

WAUCONDA

State

Zip

60084

County

LAKE

Ever Disciplined

LastModifiedDate

09/26/2006