SUMANTA MITRA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

SUMANTA

Last Name

MITRA

Suffix

Business Name

SUMANTA MITRA MD

Original Issue Date

03/25/1985

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021