JAMES DOUGLAS DIETERICH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

ACTIVE

Business

Title

First Name

JAMES

Middle

DOUGLAS

Last Name

DIETERICH

Business Name

JAMES DOUGLAS DIETERICH MD

Original Issue Date

08/01/2022

Effective Date

05/09/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2023