DEEPA GURUSAMY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066545

License Status

EXPIRED

Business

Title

First Name

DEEPA

Last Name

GURUSAMY

Business Name

DEEPA GURUSAMY MD

Original Issue Date

09/01/2015

Effective Date

09/01/2015

Expiration Date

08/31/2018

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/25/2019