JHARED MICHAEL BLACK DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****33

License Status

ACTIVE

Business

Title

DMD

First Name

JHARED

Middle

MICHAEL

Last Name

BLACK

Business Name

JHARED MICHAEL BLACK DMD

Original Issue Date

08/02/2016

Effective Date

10/01/2024

Expiration Date

09/30/2027

City

MATTESON

State

Zip

60443

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2024