Ohio
Board of Licensing
Black, Tina-Emergency Professional Services
Medical Board - 41.Pa Supervision Agreement
License number
41.16155-SA
Date granted
02/07/2013
Date expires
01/31/2015
Class
Medical Board - 41.Pa Supervision Agreement
Status
Active (In Renewal)
Address
18697 Bagley Rd., Middleburg Heights, OH 44130
ohiolicensing.org
ID 29533517
LAST UPDATED 2026-06-27 01:25:56 UTC
LAST UPDATED 2026-06-27 01:25:56 UTC