TIMOTHY R STIDHAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

ACTIVE

Business

Title

First Name

TIMOTHY

Middle

Last Name

STIDHAM

Business Name

TIMOTHY R STIDHAM MD

Original Issue Date

08/13/2024

Effective Date

08/13/2024

Expiration Date

07/31/2026

City

KALISPELL

State

Zip

59901

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/13/2024