SURUCHI KAMALKANT GUPTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

NOT RENEWED

Business

Title

First Name

SURUCHI

Middle

KAMALKANT

Last Name

GUPTA

Business Name

SURUCHI KAMALKANT GUPTA MD

Original Issue Date

06/21/2017

Effective Date

06/21/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021