RICHARD R BLACK DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108975

License Status

NOT RENEWED

Business

First Name

RICHARD

Middle

Last Name

BLACK

Suffix

Business Name

RICHARD R BLACK DO

Original Issue Date

04/10/2003

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

BEACHWOOD

State

Zip

44122

County

OHIO

Ever Disciplined

LastModifiedDate

01/14/2021