RAYMOND A J DIETER JR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

ACTIVE

Business

First Name

RAYMOND

Middle

A J

Last Name

DIETER

Suffix

JR MD

Business Name

RAYMOND A J DIETER JR MD

Original Issue Date

01/01/1997

Effective Date

06/09/2023

Expiration Date

07/31/2026

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/09/2023