Nicole Terese Suprovici
ActiveCalifornia license A102395
License
- Licensed by
- Medical Board of California
- License number
- A102395
- Status
- Active (Current)
- First issued
- December 28, 2007
- Expires
- July 31, 2027
- License holder
- Nicole Terese Suprovici
- Entity type
- Individual
Classifications
- Physician and Surgeon A Physicians & Surgeons
More from the license record
- License type code
- 8002
Contact
1 Main St
San Quentin, CA 94964-1000
San Quentin, CA 94964-1000
Marin County