JOHN FRANKLIN BLACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

FRANKLIN

Last Name

BLACK

Suffix

Business Name

JOHN FRANKLIN BLACK MD

Original Issue Date

04/05/2002

Effective Date

04/12/2011

Expiration Date

07/31/2014

City

MATTOON

State

Zip

61938

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020