MICHAEL MALAVE RIVERA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****50

License Status

NOT RENEWED

Business

First Name

MICHAEL

Last Name

MALAVE RIVERA

Suffix

Business Name

MICHAEL MALAVE RIVERA OD

Original Issue Date

10/24/1997

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005