KATHERINE ELIZAB BLACK Podiatrist License verification

Business Entity

INACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016003063

License Status

INACTIVE

Business

First Name

KATHERINE ELIZAB

Last Name

BLACK

Business Name

KATHERINE ELIZAB BLACK

Original Issue Date

06/27/1979

Effective Date

06/27/1979

Expiration Date

01/31/1997

City

MADISON

State

Zip

06443

County

CONNECTICUT

Ever Disciplined

LastModifiedDate

09/25/2006