MARK RICHARD STIVERS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036141995

License Status

ACTIVE

Business

First Name

MARK

Middle

RICHARD

Last Name

STIVERS

Suffix

Business Name

MARK RICHARD STIVERS MD

Original Issue Date

11/17/2016

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61705

County

MCLEAN

Ever Disciplined

LastModifiedDate

04/06/2023