LISA ELIZABETH BLACK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****22

License Status

ACTIVE

Business

First Name

LISA

Middle

ELIZABETH

Last Name

BLACK

Business Name

LISA ELIZABETH BLACK

Original Issue Date

08/02/2018

Effective Date

09/07/2024

Expiration Date

09/30/2027

City

ARLINGTON HEIGHTS

State

Zip

60005

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/07/2024