MARK JAMES BLACK DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019023555

License Status

ACTIVE

Business

Title

DDS

First Name

MARK

Middle

JAMES

Last Name

BLACK

Business Name

MARK JAMES BLACK DDS

Original Issue Date

04/14/1994

Effective Date

09/19/2024

Expiration Date

09/30/2027

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/19/2024