CHARLES SUPPLE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036032865

License Status

NOT RENEWED

Business

First Name

CHARLES

Last Name

SUPPLE

Suffix

Business Name

CHARLES SUPPLE MD

Original Issue Date

09/17/1954

Effective Date

09/17/1954

Expiration Date

07/31/1987

City

PALM SPRINGS

State

Zip

92262

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

09/20/2006