GAUTAM GUPTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036061001

License Status

NOT RENEWED

Business

First Name

GAUTAM

Last Name

GUPTA

Suffix

Business Name

GAUTAM GUPTA MD

Original Issue Date

09/11/1980

Effective Date

04/20/2011

Expiration Date

07/31/2014

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/17/2014

Case Number

2011005162

Action

Suspension

Discipline Start Date

03/21/2012

Discipline Reason

due to violation of federal laws related to healthcare.