CHAMPALAL GUPTA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036060317

License Status

INACTIVE

Business

First Name

CHAMPALAL

Last Name

GUPTA

Suffix

Business Name

CHAMPALAL GUPTA MD

Original Issue Date

05/16/1980

Effective Date

05/16/1980

Expiration Date

07/31/2002

City

BROOKFIELD

State

Zip

53045

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/09/2006