DONNIE S RIVERA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****49

License Status

NOT RENEWED

Business

First Name

DONNIE

Middle

Last Name

RIVERA

Suffix

DDS

Business Name

DONNIE S RIVERA DDS

Original Issue Date

06/11/2010

Effective Date

06/11/2010

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60660

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012