JAMES DOUGLAS DIETERICH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036161687

License Status

ACTIVE

Business

Title

First Name

JAMES

Middle

DOUGLAS

Last Name

DIETERICH

Business Name

JAMES DOUGLAS DIETERICH MD

Original Issue Date

07/27/2022

Effective Date

05/02/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2023