CLARA RENNOLDS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036044949

License Status

NOT RENEWED

Business

First Name

CLARA

Last Name

RENNOLDS

Suffix

Business Name

CLARA RENNOLDS MD

Original Issue Date

10/08/1971

Effective Date

10/08/1971

City

ASTORIA

State

Zip

61501

County

FULTON

Ever Disciplined

LastModifiedDate

03/24/2007

Case Number

1976000009

Action

Revocation

Discipline Start Date

09/03/1976