GREGORY M DIETZ DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021002544

License Status

ACTIVE

Business

First Name

GREGORY

Middle

Last Name

DIETZ

Suffix

DMD

Business Name

GREGORY M DIETZ DMD

Original Issue Date

09/23/2013

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

PEDIATRIC DENTISTRY

Ever Disciplined

LastModifiedDate

05/02/2024