MANISH GUPTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036138105

License Status

NOT RENEWED

Business

Title

First Name

MANISH

Last Name

GUPTA

Business Name

MANISH GUPTA MD

Original Issue Date

05/28/2015

Effective Date

06/10/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61603

County

PEORIA

Ever Disciplined

LastModifiedDate

11/30/2023