MARK RICHARD STIVERS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

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

PEORIA

State

Zip

61636

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023