REBECKA RIANNE LOPEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

Title

First Name

REBECKA

Middle

RIANNE

Last Name

LOPEZ

Business Name

REBECKA RIANNE LOPEZ MD

Original Issue Date

02/18/2014

Effective Date

06/26/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021