JUDITH O DISTERHOFT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

ACTIVE

Business

Title

First Name

JUDITH

Middle

Last Name

DISTERHOFT

Business Name

JUDITH O DISTERHOFT MD

Original Issue Date

02/19/2022

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023