License holder summary

EZRA T CLARK is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for EZRA T CLARK is GREENE COUNTY GENERAL HOSPITAL, 127 E INDIANA AVE, BLOOMFIELD IN 47424. This licensed professional license is not current. The license was granted 01/29/1993 and expired on 06/30/1997.

Indiana

Professional Licensing Agency

EZRA T CLARK
Controlled Substance Registration - Physician
License number
01041070B
Date granted
01/29/1993
Date expires
06/30/1997
Class
Controlled Substance Registration - Physician
Status
Expired
Address
GREENE COUNTY GENERAL HOSPITAL, 127 E INDIANA AVE, BLOOMFIELD IN 47424
indianalicensing.org
ID 5823581
LAST UPDATED 2024-02-16 10:04:26 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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