PAIGE BLACK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****66

License Status

ACTIVE

Business

First Name

PAIGE

Last Name

BLACK

Business Name

PAIGE BLACK

Original Issue Date

08/13/2018

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/02/2024