CHARLES JOSEPH WINE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036041476

License Status

NOT RENEWED

Business

First Name

CHARLES JOSEPH

Last Name

WINE

Suffix

Business Name

CHARLES JOSEPH WINE MD

Original Issue Date

11/17/1967

Effective Date

11/17/1967

Expiration Date

07/31/2002

City

OKLAHOMA CITY

State

Zip

73120

County

OKLAHOMA

Ever Disciplined

LastModifiedDate

10/09/2006