License holder summary

BLACK, BRENTON L is a Medical - Resident Physician licensed to practice in Georgia. The address on file for BLACK, BRENTON L is 220 UNDERWOOD ST., Decatur 30030. This doctor license is not current. The license was granted 08/06/2004 and expired on 06/30/2007.

Georgia

Composite Medical Board

BLACK, BRENTON L
Medical - Resident Physician
License number
000760
Date granted
08/06/2004
Date expires
06/30/2007
Class
Medical - Resident Physician
Status
Lapsed
Address
220 UNDERWOOD ST.
georgiadoctors.net
ID 38114562
LAST UPDATED 2024-02-06 03:54:51 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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