ANDREA RIVERA-SEPULVEDA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

Title

First Name

ANDREA

Last Name

RIVERA-SEPULVEDA

Business Name

ANDREA RIVERA-SEPULVEDA MD

Original Issue Date

12/26/2018

Effective Date

12/26/2018

Expiration Date

09/30/2020

City

SAINT LOUIS

State

Zip

63104

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021