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Data Detail

Name: Shawn La Trece Clark 

Designation: Ph.D.

Issue Date: 2/11/2022

Expiration Date: 6/30/2024

License Number: 62 1111

Disciplinary Action: None

Company: G.V. Sonny Montgomery VAMC

City: Jackson

State: MS

Zip: 39216

Work Phone: (601) 362-4471  Ext:

Civil Commitment Certification: