License holder summary

Stacy H Black, DA is a Dental Assistant licensed to practice in New Mexico. The address on file for Stacy H Black, DA is Santa Fe, NM, 87501. This licensed professional license is not current. The license was granted 04/11/2005 and expired on 06/30/2008.

New Mexico

Regulation & Licensing Department

Stacy H Black, DA
Dental Assistant
License number
DA2809
Date granted
04/11/2005
Date expires
06/30/2008
Class
Dental Assistant
Status
Revoked
Address
Santa Fe, NM, 87501
licensingnm.com
ID 4320648
LAST UPDATED 2024-05-02 20:46:36 UTC

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