SUSHAN GUPTA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077875

License Status

EXPIRED

Business

Title

First Name

SUSHAN

Last Name

GUPTA

Business Name

SUSHAN GUPTA MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/30/2024