License holder summary

BLACK, ANGELIQUE V is a Medical - Physician Assistant licensed to practice in Georgia. The address on file for BLACK, ANGELIQUE V is 2415 BECKENHAM PLACE, Dacula 30019. This doctor license is not current. The license was granted 02/05/2001 and expired on 12/31/2006.

Georgia

Composite Medical Board

BLACK, ANGELIQUE V
Medical - Physician Assistant
License number
003597
Date granted
02/05/2001
Date expires
12/31/2006
Class
Medical - Physician Assistant
Status
Lapsed
Address
2415 BECKENHAM PLACE
georgiadoctors.net
ID 38096631
LAST UPDATED 2024-02-20 18:22:33 UTC

This website is unaffiliated with the Composite Medical Board. Please verify all information directly with the relevant official government authority.

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