THEODORE THOMAS DEITZ MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

ACTIVE

Business

Title

First Name

THEODORE

Middle

THOMAS

Last Name

DEITZ

Business Name

THEODORE THOMAS DEITZ MD

Original Issue Date

02/14/2025

Effective Date

02/14/2025

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/14/2025