FRANK J SUPPA DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

ACTIVE

Business

Title

First Name

FRANK

Middle

Last Name

SUPPA

Business Name

FRANK J SUPPA DO

Original Issue Date

07/22/2021

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

EAST ROCKAWAY

State

Zip

11518

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/07/2023