TIMOTHY J KIETZMAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

ACTIVE

Business

First Name

TIMOTHY

Middle

Last Name

KIETZMAN

Suffix

Business Name

TIMOTHY J KIETZMAN MD

Original Issue Date

07/21/2011

Effective Date

04/15/2023

Expiration Date

07/31/2026

City

WHEATON

State

Zip

60187

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/15/2023