OLE DIERKS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036105628

License Status

NOT RENEWED

Business

First Name

OLE

Last Name

DIERKS

Suffix

Business Name

OLE DIERKS MD

Original Issue Date

09/24/2001

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008