STEVEN E DIEBOLD MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

ACTIVE

Business

First Name

STEVEN E

Last Name

DIEBOLD

Suffix

Business Name

STEVEN E DIEBOLD MD

Original Issue Date

12/24/1992

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023