SHANKHO SHUVRO GANGULI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

Title

First Name

SHANKHO

Middle

SHUVRO

Last Name

GANGULI

Business Name

SHANKHO SHUVRO GANGULI MD

Original Issue Date

01/08/2019

Effective Date

01/08/2019

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62701

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021