ANTON N DIETZEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036149703

License Status

ACTIVE

Business

Title

First Name

ANTON

Middle

Last Name

DIETZEN

Business Name

ANTON N DIETZEN MD

Original Issue Date

06/15/2019

Effective Date

06/27/2023

Expiration Date

07/31/2026

City

LOMBARD

State

Zip

60148

County

DUPAGE

Ever Disciplined

LastModifiedDate

06/27/2023