PETER C BLACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036048209

License Status

NOT RENEWED

Business

First Name

PETER C

Last Name

BLACK

Suffix

Business Name

PETER C BLACK MD

Original Issue Date

08/23/1973

Effective Date

08/23/1973

Expiration Date

07/31/1987

City

MERRILLVILLE

State

Zip

46410

County

INDIANA

Ever Disciplined

LastModifiedDate

09/20/2006