VICKI L BLACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036051367

License Status

NOT RENEWED

Business

First Name

VICKI L

Last Name

BLACK

Suffix

Business Name

VICKI L BLACK MD

Original Issue Date

08/12/1975

Effective Date

08/12/1975

City

OAK PARK

State

Zip

60304

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006