ANUJA D GUPTA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

First Name

ANUJA

Middle

Last Name

GUPTA

Business Name

ANUJA D GUPTA

Original Issue Date

08/02/2007

Effective Date

07/30/2014

Expiration Date

07/31/2017

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020