KAREN A DIEFENBACH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

First Name

KAREN

Middle

Last Name

DIEFENBACH

Suffix

Business Name

KAREN A DIEFENBACH MD

Original Issue Date

03/10/2000

Effective Date

03/10/2000

Expiration Date

07/31/2002

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006