PUJA GUPTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

PUJA

Last Name

GUPTA

Suffix

Business Name

PUJA GUPTA MD

Original Issue Date

07/17/2006

Effective Date

07/17/2006

Expiration Date

07/31/2008

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008