SUMANTA MITRA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036050890

License Status

NOT RENEWED

Business

First Name

SUMANTA

Last Name

MITRA

Suffix

Business Name

SUMANTA MITRA MD

Original Issue Date

03/21/1975

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021