MICHAEL RICHARD BLACK Clinical Psychologist License verification

Business Entity

ACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071008134

License Status

ACTIVE

Business

First Name

MICHAEL

Middle

RICHARD

Last Name

BLACK

Business Name

MICHAEL RICHARD BLACK

Original Issue Date

05/04/2011

Effective Date

08/29/2024

Expiration Date

09/30/2026

City

CHICAGO

State

Zip

60639

County

COOK

Ever Disciplined

LastModifiedDate

08/29/2024