GARGI DNYANESH GUPTE Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****35

License Status

INOPERATIVE

Business

First Name

GARGI

Middle

DNYANESH

Last Name

GUPTE

Business Name

GARGI DNYANESH GUPTE

Original Issue Date

12/26/2019

Effective Date

01/06/2022

Expiration Date

03/01/2024

City

PEORIA

State

Zip

61603

County

PEORIA

Ever Disciplined

LastModifiedDate

12/06/2023