VIVIAN W SALAZAR Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

ACTIVE

Business

First Name

VIVIAN W

Last Name

SALAZAR

Business Name

VIVIAN W SALAZAR

Original Issue Date

04/09/1991

Effective Date

04/24/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/24/2023