EMMANUEL NIEVA RODRIGUEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

Title

First Name

EMMANUEL

Middle

NIEVA

Last Name

RODRIGUEZ

Business Name

EMMANUEL NIEVA RODRIGUEZ MD

Original Issue Date

01/31/2019

Effective Date

01/31/2019

Expiration Date

09/30/2020

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021