KEVIN MANUEL RIVERA VAZQUEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

Title

First Name

KEVIN

Middle

MANUEL

Last Name

RIVERA VAZQUEZ

Business Name

KEVIN MANUEL RIVERA VAZQUEZ MD

Original Issue Date

12/05/2011

Effective Date

12/05/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014