DANIEL DOUGLAS RIVARD MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050245

License Status

CANCELLED

Business

First Name

DANIEL

Middle

DOUGLAS

Last Name

RIVARD

Suffix

Business Name

DANIEL DOUGLAS RIVARD MD

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2008

City

LONG GROVE

State

Zip

60047

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006