CHARLES THOMAS BLACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036070918

License Status

NOT RENEWED

Business

First Name

CHARLES

Middle

THOMAS

Last Name

BLACK

Suffix

Business Name

CHARLES THOMAS BLACK MD

Original Issue Date

06/17/1985

Effective Date

06/17/1985

Expiration Date

07/31/1987

City

INDIANAPOLIS

State

Zip

46227

County

INDIANA

Ever Disciplined

LastModifiedDate

02/26/2014