License holder summary

Stacy R. Black is a Respiratory Care Practitioner licensed to practice in Indiana. The address on file for Stacy R. Black is Fort Wayne IN 46805. This licensed professional license is current. The license was granted 08/18/2014 and expired on 12/31/2014.

Indiana

Professional Licensing Agency

Stacy R. Black
Respiratory Care Practitioner
License number
30008721A
Date granted
08/18/2014
Date expires
12/31/2014
Class
Respiratory Care Practitioner
Status
Active
Address
Fort Wayne IN 46805
indianalicensing.org
ID 29378145
LAST UPDATED 2024-03-18 15:29:39 UTC

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