ELIZABETH B BLACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

First Name

ELIZABETH B

Last Name

BLACK

Suffix

Business Name

ELIZABETH B BLACK MD

Original Issue Date

05/18/1982

Effective Date

05/18/1982

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011