MADAN L GUPTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

First Name

MADAN L

Last Name

GUPTA

Suffix

Business Name

MADAN L GUPTA MD

Original Issue Date

01/01/1997

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021