ZACHARY CANNON DIETCH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

ACTIVE

Business

Title

First Name

ZACHARY

Middle

CANNON

Last Name

DIETCH

Business Name

ZACHARY CANNON DIETCH MD

Original Issue Date

06/03/2020

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/13/2023