CORY LYNN DIETZ MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109143

License Status

INACTIVE

Business

First Name

CORY

Middle

LYNN

Last Name

DIETZ

Suffix

Business Name

CORY LYNN DIETZ MD

Original Issue Date

04/30/2003

Effective Date

04/14/2011

Expiration Date

07/31/2014

City

COLORADO SPRINGS

State

Zip

80927

Ever Disciplined

LastModifiedDate

06/21/2014