SURYA N GUPTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036148834

License Status

NOT RENEWED

Business

Title

First Name

SURYA

Middle

Last Name

GUPTA

Business Name

SURYA N GUPTA MD

Original Issue Date

03/28/2019

Effective Date

09/03/2020

Expiration Date

07/31/2023

City

PEKIN

State

Zip

61554

Ever Disciplined

LastModifiedDate

11/30/2023