DANIEL MERRILL DIERFELDT DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059121

License Status

EXPIRED

Business

First Name

DANIEL

Middle

MERRILL

Last Name

DIERFELDT

Suffix

Business Name

DANIEL MERRILL DIERFELDT DO

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

Family Practice

Ever Disciplined

LastModifiedDate

03/13/2015