SMITA GUPTA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050508

License Status

EXPIRED

Business

First Name

SMITA

Last Name

GUPTA

Suffix

Business Name

SMITA GUPTA MD

Original Issue Date

08/15/2005

Effective Date

08/15/2005

Expiration Date

08/14/2007

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

08/29/2007