ADAM J BLACK Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

ACTIVE

Business

First Name

ADAM

Middle

Last Name

BLACK

Business Name

ADAM J BLACK

Original Issue Date

04/23/1998

Effective Date

05/02/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60613

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2023