JAY WILLIAM DIECKHOFF MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

NOT RENEWED

Business

First Name

JAY WILLIAM

Last Name

DIECKHOFF

Suffix

Business Name

JAY WILLIAM DIECKHOFF MD

Original Issue Date

08/27/1982

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

QUINCY

State

Zip

62301

County

ADAMS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021