STEPHEN THEODORE LIETZ MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036063520

License Status

INACTIVE

Business

First Name

STEPHEN THEODORE

Last Name

LIETZ

Suffix

Business Name

STEPHEN THEODORE LIETZ MD

Original Issue Date

11/05/1981

Effective Date

11/05/1981

Expiration Date

07/31/2005

City

RIVERSIDE

State

Zip

60546

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006