License holder summary

MARK DOUGLAS SUPROCK is a Medicine - Written Agreement licensed to practice in Pennsylvania. The address on file for MARK DOUGLAS SUPROCK is 300 STATE STREET SUITE 301 H ERIE PA 16507. This licensed professional license is not current. The license was granted 05/12/2003.

Pennsylvania

Department of State

MARK DOUGLAS SUPROCK
Medicine - Written Agreement
License number
MX001588
Date granted
05/12/2003
Class
Medicine - Written Agreement
Status
Inactive
Address
300 STATE STREET SUITE 301 H ERIE PA 16507
palicensing.org
ID 16662415
LAST UPDATED 2024-03-22 11:25:44 UTC

This website is unaffiliated with the Department of State. Please verify all information directly with the relevant official government authority.

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