THOMAS JEFFREY DIETRICH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036100285

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

JEFFREY

Last Name

DIETRICH

Suffix

Business Name

THOMAS JEFFREY DIETRICH MD

Original Issue Date

06/01/1999

Effective Date

06/01/1999

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006