License holder summary

Mark Daniel Clark is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Mark Daniel Clark is 1739 N. 4th St., Terre Haute IN 47804-4002. This licensed professional license is current. The license was granted 03/18/2004 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Mark Daniel Clark
Controlled Substance Registration - Physician
License number
01034547C
Date granted
03/18/2004
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
1739 N. 4th St., Terre Haute IN 47804-4002
indianalicensing.org
ID 5925966
LAST UPDATED 2024-02-02 11:02:03 UTC

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