PRAMOD RAMJANAK GUPTA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

Title

First Name

PRAMOD

Middle

RAMJANAK

Last Name

GUPTA

Business Name

PRAMOD RAMJANAK GUPTA MD

Original Issue Date

08/23/2023

Effective Date

08/23/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

08/23/2023