ALBERT J DIETZ JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

ALBERT J

Last Name

DIETZ JR

Suffix

Business Name

ALBERT J DIETZ JR MD

Original Issue Date

05/20/2005

Effective Date

07/21/2008

Expiration Date

07/31/2011

City

WAUKEGAN

State

Zip

60085

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011