MICHAEL E CLARK DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016002692

License Status

NOT RENEWED

Business

Title

DPM

First Name

MICHAEL

Middle

Last Name

CLARK

Business Name

MICHAEL E CLARK DPM

Original Issue Date

06/29/1972

Effective Date

11/08/2020

Expiration Date

01/31/2023

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

03/31/2023