COREY A BLACK Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038027

License Status

EXPIRED

Business

First Name

COREY

Middle

Last Name

BLACK

Business Name

COREY A BLACK

Original Issue Date

07/01/1998

Effective Date

07/01/1998

Expiration Date

06/21/2001

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006