Maryland Board of Physicians Practitioner Profile System
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This data was extracted on 12/11/2017
Clark, Melissa Aviva
License and Education
License No.: D70056 
Special License Category  
Accepts Medicaid: Yes 
Maintains Malpractice Ins: data not available 
Graduated: 1999 
License Status: Active 
Date License Issued: 12/07/2009 
License Expiration: 09/30/2018 
  Primary Practice Setting
CCI Health & Wellness 
1398 Lamberton Dr 
Suite 201 
Silver Spring 
MD  20902
  Public Address
CCI Health & Wellness 
1398 Lamberton Dr 
Suite 201 
Silver Spring 
MD  20902
        Graduated from: WRIGHT STATE UNIV SCH OF MED
Postgraduate Training Program Concentration
Masonic Hospital, Chicago, IL Family Medicine
Specialty Board Certification
by ABMS/AOA - as reported by licensee
Family Medicine
Self-Designated Practice Area
Family Medicine
Maryland Hospital Privilege Information- as reported by licensee
Licensee has not reported privilege information for the profile site pursuant to HO 14-413.
Medical Licenses Held in Other States- as reported by licensee
Illinois
Active Supervisee - Delegation Agreement For Core Duties- as reported by licensee
 
 
Known Disciplinary Actions by any state medical board (within the past 10 years)
Summary: No actions reported during the last ten year period.
Download all Maryland Disciplinary Actions
None
Pending Charges
None
Malpractice   (Information to be taken into consideration when reviewing a Licensee's profile)
      Malpractice Judgments and Arbitration Awards (within the past 10 years)
None Reported

      Malpractice Settlements
      (If there are 3 or more settlements of $150,000 or greater within the past 5 years)
None Reported
Convictions for any crime involving moral turpitude
None reported by the courts

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