MATTHEW LOUIS BLACK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030924

License Status

EXPIRED

Business

First Name

MATTHEW LOUIS

Last Name

BLACK

Suffix

Business Name

MATTHEW LOUIS BLACK MD

Original Issue Date

05/02/1994

Effective Date

05/02/1994

Expiration Date

06/30/1997

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006