MARK A DIETZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036073450

License Status

NOT RENEWED

Business

First Name

MARK A

Last Name

DIETZ

Suffix

Business Name

MARK A DIETZ MD

Original Issue Date

08/14/1986

Effective Date

08/14/1986

Expiration Date

07/31/1990

City

CLARENDON HILLS

State

Zip

60514

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/20/2006