WALTER ALBERT BLACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036052364

License Status

NOT RENEWED

Business

First Name

WALTER ALBERT

Last Name

BLACK

Suffix

Business Name

WALTER ALBERT BLACK MD

Original Issue Date

02/13/1976

Effective Date

02/13/1976

Expiration Date

07/01/1982

City

KIMBERLING CITY

State

Zip

65686

County

MISSOURI

Ever Disciplined

LastModifiedDate

12/20/2007