JAMES E BLACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

NOT RENEWED

Business

First Name

JAMES

Middle

Last Name

BLACK

Suffix

Business Name

JAMES E BLACK MD

Original Issue Date

10/20/1995

Effective Date

06/10/2008

Expiration Date

07/31/2011

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011

Case Number

2004001573

Action

Probation

Discipline Start Date

07/25/2005

Discipline End Date

02/01/2010