PHILIP THIEM DEIBEL Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056036

License Status

EXPIRED

Business

First Name

PHILIP

Middle

THIEM

Last Name

DEIBEL

Business Name

PHILIP THIEM DEIBEL

Original Issue Date

06/23/2012

Effective Date

06/23/2012

Expiration Date

06/22/2013

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

10/07/2013