EDWARD B DIETHRICH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036065661

License Status

NOT RENEWED

Business

First Name

EDWARD B

Last Name

DIETHRICH

Suffix

Business Name

EDWARD B DIETHRICH MD

Original Issue Date

11/15/1982

Effective Date

05/01/2014

Expiration Date

07/31/2017

City

PHOENIX

State

Zip

85016

County

ARIZONA

Ever Disciplined

LastModifiedDate

11/01/2017