JESSICA MARIE DIETHELM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

ACTIVE

Business

First Name

JESSICA

Middle

MARIE

Last Name

DIETHELM

Suffix

Business Name

JESSICA MARIE DIETHELM MD

Original Issue Date

02/28/2008

Effective Date

05/12/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/12/2023