BRIAN E BLACK MD - Medical Doctor License in Wisconsin | # 036072336

BRIAN E BLACK MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072336

License Status

INACTIVE

Business

N

First Name

BRIAN E

Last Name

BLACK

Suffix

MD

Business Name

BRIAN E BLACK MD

Original Issue Date

02/20/1986

Effective Date

02/20/1986

Expiration Date

07/31/1996

State

WI

Ever Disciplined

N

LastModifiedDate

01/09/2019