VIVARA RAGES Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****59

License Status

ACTIVE

Business

First Name

VIVARA

Last Name

RAGES

Business Name

VIVARA RAGES

Original Issue Date

04/27/2022

Effective Date

12/09/2025

Expiration Date

03/01/2028

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/09/2025