ERIC A KIVISTO DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036091073

License Status

ACTIVE

Business

First Name

ERIC A

Last Name

KIVISTO

Suffix

Business Name

ERIC A KIVISTO DO

Original Issue Date

06/27/1995

Effective Date

07/14/2023

Expiration Date

07/31/2026

City

PRINCETON

State

Zip

61356

County

BUREAU

Ever Disciplined

LastModifiedDate

08/08/2023