ERIC TIEDE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

ACTIVE

Business

Title

First Name

ERIC

Last Name

TIEDE

Business Name

ERIC TIEDE MD

Original Issue Date

05/03/2022

Effective Date

06/06/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/06/2023