LANCE DION RIVAS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003145

License Status

NOT RENEWED

Business

First Name

LANCE

Middle

DION

Last Name

RIVAS

Business Name

LANCE DION RIVAS

Original Issue Date

11/08/2007

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

12/22/2010