ROBERT MICHAEL DIETZ MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057720

License Status

EXPIRED

Business

First Name

ROBERT

Middle

MICHAEL

Last Name

DIETZ

Suffix

Business Name

ROBERT MICHAEL DIETZ MD

Original Issue Date

06/24/2010

Effective Date

06/24/2010

Expiration Date

06/23/2013

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

10/07/2013