SUPRIYA GUPTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036143790

License Status

NOT RENEWED

Business

Title

First Name

SUPRIYA

Last Name

GUPTA

Business Name

SUPRIYA GUPTA MD

Original Issue Date

07/07/2017

Effective Date

07/07/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021