STANLEY J SIDWELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

ACTIVE

Business

First Name

STANLEY

Middle

Last Name

SIDWELL

Suffix

Business Name

STANLEY J SIDWELL MD

Original Issue Date

06/09/1982

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023