MARK RICHARD STIVERS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042737

License Status

EXPIRED

Business

First Name

MARK

Middle

RICHARD

Last Name

STIVERS

Suffix

Business Name

MARK RICHARD STIVERS MD

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2004

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006