MICHAEL DIETRICH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

ACTIVE

Business

Title

First Name

MICHAEL

Last Name

DIETRICH

Prefix

Business Name

MICHAEL DIETRICH MD

Original Issue Date

08/25/2023

Effective Date

08/25/2023

Expiration Date

07/31/2026

City

NAPERVILLE

State

Zip

60563

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/25/2023