ALEXANDRA THERESA BLACK Speech-Language Pathologist License verification

Business Entity

INACTIVE

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146010030

License Status

INACTIVE

Business

First Name

ALEXANDRA

Middle

THERESA

Last Name

BLACK

Business Name

ALEXANDRA THERESA BLACK

Original Issue Date

09/11/2009

Effective Date

09/11/2009

Expiration Date

10/31/2011

City

PHILADELPHIA

State

Zip

19128

County

PENNSYLVANIA

Ever Disciplined

LastModifiedDate

08/03/2011