JONATHAN JACOB DIETRICH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125081580

License Status

EXPIRED

Business

Title

First Name

JONATHAN

Middle

JACOB

Last Name

DIETRICH

Business Name

JONATHAN JACOB DIETRICH MD

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

06/30/2024

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/30/2024