SHIVA GUPTA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036165

License Status

EXPIRED

Business

First Name

SHIVA

Last Name

GUPTA

Business Name

SHIVA GUPTA

Original Issue Date

05/19/1997

Effective Date

05/19/1997

Expiration Date

06/24/2000

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006