SHIVA GUPTA Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102547

License Status

INACTIVE

Business

First Name

SHIVA

Last Name

GUPTA

Business Name

SHIVA GUPTA

Original Issue Date

05/25/2000

Effective Date

05/27/2011

Expiration Date

07/31/2014

City

LONG GROVE

State

Zip

60047

County

LAKE

Ever Disciplined

LastModifiedDate

04/08/2014