JAY WILLIAM DIECKHOFF MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125013323

License Status

EXPIRED

Business

First Name

JAY WILLIAM

Last Name

DIECKHOFF

Suffix

Business Name

JAY WILLIAM DIECKHOFF MD

Original Issue Date

07/14/1981

Effective Date

07/14/1981

Expiration Date

06/22/1983

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006