JOSE JULIAN RIVERA RODRIGUEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

First Name

JOSE

Middle

JULIAN RIVERA

Last Name

RODRIGUEZ

Suffix

Business Name

JOSE JULIAN RIVERA RODRIGUEZ MD

Original Issue Date

07/09/2007

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017