PAVAN KUMAR GUPTA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

ACTIVE

Business

Title

First Name

PAVAN

Middle

KUMAR

Last Name

GUPTA

Business Name

PAVAN KUMAR GUPTA MD

Original Issue Date

06/18/2012

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

O'FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023