Louisiana
Board of Licensing
VIVERITO MARK IVES
Medical
License number
POLY.000289
Date expires
12/31/2014
Class
Medical
Status
Active
Address
4570 Bluebonnet Blvd., Ste. A, Baton Rouge, LA 70809
louisianalicensing.com
ID 22012012
LAST UPDATED 2026-05-14 14:47:15 UTC
LAST UPDATED 2026-05-14 14:47:15 UTC