Louisiana
Board of Licensing
Black, Destin R.
Medical
License number
MD.024725
Date expires
08/31/2015
Class
Medical
Status
Active
Address
2600 Kings Hwy. Ste 420, Shreveport, LA 71103
louisianalicensing.com
ID 21883575
LAST UPDATED 2024-04-09 22:19:48 UTC
LAST UPDATED 2024-04-09 22:19:48 UTC