TRACY LYNN LAWRENCE-BLACK MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036118922

License Status

INACTIVE

Business

Title

First Name

TRACY

Middle

LYNN

Last Name

LAWRENCE-BLACK

Business Name

TRACY LYNN LAWRENCE-BLACK MD

Original Issue Date

07/11/2007

Effective Date

11/10/2008

Expiration Date

07/31/2011

City

WILMETTE

State

Zip

60091

County

COOK

Ever Disciplined

LastModifiedDate

09/06/2011