KEVIN JOHN BLACK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036177744

License Status

ACTIVE

Business

Title

First Name

KEVIN

Middle

JOHN

Last Name

BLACK

Business Name

KEVIN JOHN BLACK MD

Original Issue Date

11/03/2025

Effective Date

11/03/2025

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63110

Ever Disciplined

LastModifiedDate

11/03/2025