LANCE DION RIVAS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****23

License Status

NOT RENEWED

Business

First Name

LANCE

Middle

DION

Last Name

RIVAS

Business Name

LANCE DION RIVAS

Original Issue Date

12/06/2007

Effective Date

12/06/2007

Expiration Date

03/01/2010

City

MORTON GROVE

State

Zip

60053

County

COOK

Ever Disciplined

LastModifiedDate

12/22/2010