RICHARD ETHAN BIVIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036103598

License Status

ACTIVE

Business

First Name

RICHARD

Middle

ETHAN

Last Name

BIVIN

Suffix

Business Name

RICHARD ETHAN BIVIN MD

Original Issue Date

10/03/2000

Effective Date

05/12/2023

Expiration Date

07/31/2026

City

LINCOLN

State

Zip

62656

County

LOGAN

Ever Disciplined

LastModifiedDate

05/12/2023