MOLLY MAXINE DIAZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

Title

First Name

MOLLY

Middle

MAXINE

Last Name

DIAZ

Business Name

MOLLY MAXINE DIAZ MD

Original Issue Date

05/02/2016

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60622

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021