DANIEL RIVERA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

NOT RENEWED

Business

Title

First Name

DANIEL

Last Name

RIVERA

Business Name

DANIEL RIVERA MD

Original Issue Date

10/03/2016

Effective Date

10/03/2016

Expiration Date

07/31/2017

City

GALESBURG

State

Zip

61401

County

KNOX

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017