SUSAN J SUP DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019017286

License Status

ACTIVE

Business

First Name

SUSAN J

Last Name

SUP DDS

Business Name

SUSAN J SUP DDS

Original Issue Date

06/07/1980

Effective Date

09/30/2024

Expiration Date

09/30/2027

City

SONOMA

State

Zip

95476

Ever Disciplined

LastModifiedDate

07/31/2025