License holder summary

NISSI SHARON SUPPOGU is a Graduate Medical Trainee licensed to practice in Pennsylvania. The address on file for NISSI SHARON SUPPOGU is Scranton PA 18508. This medical practitioner license is current. The license was granted 03/14/2013 and expired on 08/01/2016.

Department of State

Board of Medicine

NISSI SHARON SUPPOGU
Graduate Medical Trainee
License number
MT203219
Date granted
03/14/2013
Date expires
08/01/2016
Class
Graduate Medical Trainee
Status
Active
Address
Scranton PA 18508
medicinepa.com
ID 37570788
LAST UPDATED 2026-05-28 20:33:39 UTC

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