DAVID L DIEDRICHSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046448

License Status

NOT RENEWED

Business

First Name

DAVID L

Last Name

DIEDRICHSEN

Suffix

Business Name

DAVID L DIEDRICHSEN MD

Original Issue Date

09/18/1972

Effective Date

09/18/1972

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006