STEPHANIE MICHELLE BLACK MD - Medical Doctor License in Missouri | # 036108390

STEPHANIE MICHELLE BLACK MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108390

License Status

NOT RENEWED

Business

N

First Name

STEPHANIE

Middle

MICHELLE

Last Name

BLACK

Suffix

MD

Business Name

STEPHANIE MICHELLE BLACK MD

Original Issue Date

01/03/2003

Effective Date

01/03/2003

Expiration Date

07/31/2005

State

MO

Ever Disciplined

N

LastModifiedDate

10/09/2006