STEVEN JOHN LIDVALL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

NOT RENEWED

Business

First Name

STEVEN JOHN

Last Name

LIDVALL

Suffix

Business Name

STEVEN JOHN LIDVALL MD

Original Issue Date

01/01/1997

Effective Date

05/05/2011

Expiration Date

07/31/2014

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017