JOHN RYAN LIDVALL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036132696

License Status

ACTIVE

Business

First Name

JOHN

Middle

RYAN

Last Name

LIDVALL

Suffix

Business Name

JOHN RYAN LIDVALL MD

Original Issue Date

05/01/2013

Effective Date

06/16/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

06/16/2023