CAROL SUSAN BLACK MD - Medical Doctor License in Illinois | # 036065225

CAROL SUSAN BLACK MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036065225

License Status

NOT RENEWED

Business

N

First Name

CAROL SUSAN

Last Name

BLACK

Suffix

MD

Business Name

CAROL SUSAN BLACK MD

Original Issue Date

08/20/1982

Effective Date

08/20/1982

Expiration Date

07/31/2005

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006