COREY A BLACK - Medical Doctor License in Illinois | # 036103860

COREY A BLACK

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036103860

License Status

NOT RENEWED

Business

N

First Name

COREY

Middle

A

Last Name

BLACK

Business Name

COREY A BLACK

Original Issue Date

11/29/2000

Effective Date

06/11/2020

Expiration Date

07/31/2023

State

IL

Ever Disciplined

N

LastModifiedDate

11/30/2023