SURAJ AMAR GUPTA MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049150234

License Status

NOT RENEWED

Business

Title

First Name

SURAJ

Middle

AMAR

Last Name

GUPTA

Business Name

SURAJ AMAR GUPTA MD

Original Issue Date

08/22/2003

Effective Date

08/22/2003

Expiration Date

03/31/2006

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006