MAMTA GUPTA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069746

License Status

CANCELLED

Business

Title

First Name

MAMTA

Last Name

GUPTA

Business Name

MAMTA GUPTA MD

Original Issue Date

03/01/2017

Effective Date

03/01/2017

Expiration Date

02/28/2018

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Neuroradiology

Ever Disciplined

LastModifiedDate

06/15/2018