SAMIR GUPTA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

First Name

SAMIR

Last Name

GUPTA

Business Name

SAMIR GUPTA

Original Issue Date

06/23/2005

Effective Date

06/07/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60607

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021