DIANE LOUISE THIEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036058478

License Status

NOT RENEWED

Business

First Name

DIANE LOUISE

Last Name

THIEL

Suffix

Business Name

DIANE LOUISE THIEL MD

Original Issue Date

03/22/1979

Effective Date

03/22/1979

Expiration Date

07/31/1984

City

TIFTON

State

Zip

31794

County

GEORGIA

Ever Disciplined

LastModifiedDate

09/20/2006