SHELBY ANN BLACK Speech-Language Pathologist License verification

Business Entity

EXPIRED

License Type

Speech-Language Pathologist

Description

LICENSED SPEECH LANGUAGE PATHOLOGY TEMPORARY

License Number

242007187

License Status

EXPIRED

Business

First Name

SHELBY

Middle

ANN

Last Name

BLACK

Business Name

SHELBY ANN BLACK

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

01/01/2025

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

10/29/2025