JEFFREY F DIETZ Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036113304

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

Last Name

DIETZ

Business Name

JEFFREY F DIETZ

Original Issue Date

03/22/2005

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008