STEVEN JOHN LIDVALL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036059658

License Status

NOT RENEWED

Business

First Name

STEVEN JOHN

Last Name

LIDVALL

Suffix

Business Name

STEVEN JOHN LIDVALL MD

Original Issue Date

10/26/1979

Effective Date

04/24/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/01/2017