PAVAN KUMAR GUPTA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071971

License Status

CANCELLED

Business

Title

First Name

PAVAN

Middle

KUMAR

Last Name

GUPTA

Business Name

PAVAN KUMAR GUPTA DO

Original Issue Date

06/22/2018

Effective Date

06/22/2018

Expiration Date

06/21/2021

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/11/2018