ERIC DONALD DICHSEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033895

License Status

EXPIRED

Business

First Name

ERIC DONALD

Last Name

DICHSEN

Suffix

Business Name

ERIC DONALD DICHSEN MD

Original Issue Date

08/17/1995

Effective Date

08/17/1995

Expiration Date

08/14/1997

City

SCOTT AFB

State

Zip

62225

County

SAINT CLAIR

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006