VENKATA SRIKAKULAM GUPTA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

ACTIVE

Business

Title

First Name

VENKATA

Middle

SRIKAKULAM

Last Name

GUPTA

Business Name

VENKATA SRIKAKULAM GUPTA MD

Original Issue Date

11/13/2024

Effective Date

11/13/2024

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/13/2024