RONALD M SUPRENANT Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072295

License Status

NOT RENEWED

Business

First Name

RONALD M

Last Name

SUPRENANT

Business Name

RONALD M SUPRENANT

Original Issue Date

01/28/1986

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

11/06/2008