COREY A BLACK - Medical Doctor License in Illinois | # 125038027

COREY A BLACK

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038027

License Status

EXPIRED

Business

N

First Name

COREY

Middle

A

Last Name

BLACK

Business Name

COREY A BLACK

Original Issue Date

07/01/1998

Effective Date

07/01/1998

Expiration Date

06/21/2001

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006