BEVERLY ANN BLACK - Dentist License in Illinois | # 020001846

BEVERLY ANN BLACK

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001846

License Status

INACTIVE

Business

N

First Name

BEVERLY ANN

Last Name

BLACK

Business Name

BEVERLY ANN BLACK

Original Issue Date

07/12/1972

Effective Date

09/30/2004

Expiration Date

09/30/2006

State

IL

Ever Disciplined

N

LastModifiedDate

07/24/2006