SHIVANI GUPTA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053566

License Status

CANCELLED

Business

First Name

SHIVANI

Last Name

GUPTA

Suffix

Business Name

SHIVANI GUPTA MD

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2010

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

06/12/2007