JOHN GILBERT DIETRICH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036039228

License Status

NOT RENEWED

Business

First Name

JOHN GILBERT

Last Name

DIETRICH

Suffix

Business Name

JOHN GILBERT DIETRICH MD

Original Issue Date

08/17/1964

Effective Date

04/24/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021