STEPHANIE RACHEL BLACK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036097246

License Status

ACTIVE

Business

First Name

STEPHANIE

Middle

RACHEL

Last Name

BLACK

Suffix

Business Name

STEPHANIE RACHEL BLACK MD

Original Issue Date

02/02/1998

Effective Date

05/03/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

05/03/2023