RAVI P GUPTA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

First Name

RAVI P

Last Name

GUPTA

Business Name

RAVI P GUPTA

Original Issue Date

04/29/1996

Effective Date

04/29/1996

Expiration Date

07/31/1999

City

MELROSE PARK

State

Zip

60160

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006