JEFFREY F DIETZ Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045110

License Status

EXPIRED

Business

First Name

JEFFREY

Middle

Last Name

DIETZ

Business Name

JEFFREY F DIETZ

Original Issue Date

06/18/2002

Effective Date

06/18/2002

Expiration Date

06/18/2005

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

09/22/2006