SANDEEP K GUPTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

NOT RENEWED

Business

First Name

SANDEEP K

Last Name

GUPTA

Suffix

Business Name

SANDEEP K GUPTA MD

Original Issue Date

09/16/1992

Effective Date

06/08/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021