RONALD M SUPRENANT Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

First Name

RONALD M

Last Name

SUPRENANT

Business Name

RONALD M SUPRENANT

Original Issue Date

05/13/1986

Effective Date

05/13/1986

Expiration Date

07/31/1996

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006