NICHOLAS ANTHONY DIEHL DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125082490

License Status

ACTIVE

Business

Title

First Name

NICHOLAS

Middle

ANTHONY

Last Name

DIEHL

Business Name

NICHOLAS ANTHONY DIEHL DO

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

06/30/2026

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

04/21/2023