License holder summary

BONIFACIO M RIVERA is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for BONIFACIO M RIVERA is GRAND PARK SURGICAL CENTER, 1479 EAST 84 TH PLACE, MERRILLVILLE IN 46410. This licensed professional license is not current. The license was granted 12/13/1993 and expired on 06/30/1997.

Indiana

Professional Licensing Agency

BONIFACIO M RIVERA
Controlled Substance Registration - Physician
License number
01041986B
Date granted
12/13/1993
Date expires
06/30/1997
Class
Controlled Substance Registration - Physician
Status
Expired
Address
GRAND PARK SURGICAL CENTER, 1479 EAST 84 TH PLACE, MERRILLVILLE IN 46410
indianalicensing.org
ID 5889939
LAST UPDATED 2026-06-03 11:56:04 UTC

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