JOHN M BLACK Clinical Psychologist License verification

Business Entity

NOT RENEWED

License Type

Clinical Psychologist

Description

REGISTERED PSYCHOLOGIST

License Number

072001651

License Status

NOT RENEWED

Business

First Name

JOHN M

Last Name

BLACK

Business Name

JOHN M BLACK

Original Issue Date

08/02/1973

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

09/04/2005