SURAJ AMAR GUPTA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061269

License Status

CANCELLED

Business

Title

First Name

SURAJ

Middle

AMAR

Last Name

GUPTA

Business Name

SURAJ AMAR GUPTA MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2016

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

03/19/2015