SAMIR GUPTA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

NOT RENEWED

Business

First Name

SAMIR

Last Name

GUPTA

Business Name

SAMIR GUPTA

Original Issue Date

09/26/2005

Effective Date

09/26/2005

Expiration Date

07/31/2008

City

DEERFIELD

State

Zip

60015

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020