CHARLES JOSEPH DIETZEN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036092707

License Status

INACTIVE

Business

First Name

CHARLES JOSEPH

Last Name

DIETZEN

Suffix

Business Name

CHARLES JOSEPH DIETZEN MD

Original Issue Date

05/21/1996

Effective Date

05/21/1996

Expiration Date

07/31/1999

City

CARMEL

State

Zip

46032

County

INDIANA

Ever Disciplined

LastModifiedDate

09/20/2006