WILLIAM M BLACK DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****13

License Status

ACTIVE

Business

Title

DMD

First Name

WILLIAM

Middle

Last Name

BLACK

Business Name

WILLIAM M BLACK DMD

Original Issue Date

07/23/2021

Effective Date

07/22/2024

Expiration Date

09/30/2027

City

WILMETTE

State

Zip

60091

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/22/2024