KEVIN JOHN BLACK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

ACTIVE

Business

Title

First Name

KEVIN

Middle

JOHN

Last Name

BLACK

Business Name

KEVIN JOHN BLACK MD

Original Issue Date

01/30/2026

Effective Date

01/30/2026

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63110

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/30/2026