The holder whose full name is MOYO, CHARLES T BASSOPPO,come from NEW YORK NY,hold the Physician license(NO.01030514A) which status is Revoked.
| Name | MOYO, CHARLES T BASSOPPO |
|---|---|
| License Number | 01030514A |
| License Type | Physician |
| License Status | Revoked |
| City | NEW YORK |
| State | NY |