GRANT COWAN CLARK
Medicine - Written Agreement
Pennsylvania MX000104 Inactive
This Pennsylvania license was held by GRANT COWAN CLARK. The license is no longer active. It was granted on 09/21/2001
LICENSE DETAILS
- License Number: MX000104
- Category: Written Agreement
- Status: Inactive
- Date Granted: 09/21/2001 (almost 25 years ago)
LOCATIONS
A Address
SCI MAHONOY MEDICAL DEPT 301 MOREA ROAD Frackville PA 17932