PAVAN KUMAR GUPTA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036130576

License Status

ACTIVE

Business

Title

First Name

PAVAN

Middle

KUMAR

Last Name

GUPTA

Business Name

PAVAN KUMAR GUPTA MD

Original Issue Date

06/18/2012

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

07/27/2023