SUSAN LYNNE GONNELLA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036136110

License Status

ACTIVE

Business

Title

First Name

SUSAN

Middle

LYNNE

Last Name

GONNELLA

Business Name

SUSAN LYNNE GONNELLA MD

Original Issue Date

08/01/2014

Effective Date

05/12/2023

Expiration Date

07/31/2026

City

NEW YORK

State

Zip

10016

Ever Disciplined

LastModifiedDate

05/12/2023