J RENE DADIVAS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

ACTIVE

Business

First Name

J RENE

Last Name

DADIVAS

Suffix

Business Name

J RENE DADIVAS MD

Original Issue Date

08/22/2023

Effective Date

08/22/2023

Expiration Date

07/31/2026

City

NILES

State

Zip

60714

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/22/2023