FREDERICK DIETZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036050026

License Status

NOT RENEWED

Business

First Name

FREDERICK

Last Name

DIETZ

Suffix

Business Name

FREDERICK DIETZ MD

Original Issue Date

10/10/1974

Effective Date

08/27/2020

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/30/2023