ERIC RICHARD BLACK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036133840

License Status

ACTIVE

Business

Title

First Name

ERIC

Middle

RICHARD

Last Name

BLACK

Business Name

ERIC RICHARD BLACK MD

Original Issue Date

08/22/2013

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Ever Disciplined

LastModifiedDate

04/07/2023