EDWARD EUGENE BLACK DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012452

License Status

INACTIVE

Business

First Name

EDWARD EUGENE

Last Name

BLACK

Suffix

DDS

Business Name

EDWARD EUGENE BLACK DDS

Original Issue Date

07/14/1964

Effective Date

07/14/1964

Expiration Date

09/30/1992

City

LOS ANGELES

State

Zip

90006

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

10/12/2005