THOMAS W DILLER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125015769

License Status

EXPIRED

Business

First Name

THOMAS W

Last Name

DILLER

Suffix

Business Name

THOMAS W DILLER MD

Original Issue Date

06/15/1983

Effective Date

06/15/1983

Expiration Date

06/26/1985

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006