License holder summary

BRENT D. BLACK is a Board Of Medicine licensed to practice in Idaho. The address on file for BRENT D. BLACK is 534 South 425 West Tooele UT 84074. This licensed professional license is not current. The license was granted 09/01/1983.

Idaho

Division of Occupational and Professional Licenses

BRENT D. BLACK
Board Of Medicine
License number
M-4689
Date granted
09/01/1983
Class
Board Of Medicine
Status
Canceled
Address
534 South 425 West Tooele UT 84074
idaholicensing.com
ID 48329235
LAST UPDATED 2024-03-21 20:15:31 UTC

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