BRIAN E BLACK MD - Medical Doctor License in Illinois | # 125017026

BRIAN E BLACK MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017026

License Status

EXPIRED

Business

N

First Name

BRIAN E

Last Name

BLACK

Suffix

MD

Business Name

BRIAN E BLACK MD

Original Issue Date

06/22/1984

Effective Date

06/22/1984

Expiration Date

07/01/1986

State

IL

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

N

LastModifiedDate

09/22/2006