Michigan
Department of Licensing and Regulation
HEIDI GAYLE BLACK
Physician's Assistant - Physician Assistant
License number
5601003043
Date granted
12/18/1998
Date expires
08/31/2001
Class
Physician's Assistant - Physician Assistant
Status
Lapsed
Address
Sheboygan, WI 530831377
michiganlicensing.org
ID 25990873
LAST UPDATED 2024-05-07 02:18:31 UTC
LAST UPDATED 2024-05-07 02:18:31 UTC
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