MATTHEW BLACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155268

License Status

NOT RENEWED

Business

Title

First Name

MATTHEW

Last Name

BLACK

Business Name

MATTHEW BLACK MD

Original Issue Date

01/11/2021

Effective Date

01/11/2021

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023