EMILY RENEE DIEDERICH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051503

License Status

EXPIRED

Business

First Name

EMILY

Middle

RENEE

Last Name

DIEDERICH

Suffix

Business Name

EMILY RENEE DIEDERICH MD

Original Issue Date

06/17/2006

Effective Date

06/17/2006

Expiration Date

06/16/2009

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/15/2009