SHANNON JOY ROTH Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010647

License Status

ACTIVE

Business

First Name

SHANNON

Middle

JOY

Last Name

ROTH

Business Name

SHANNON JOY ROTH

Original Issue Date

06/27/2003

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

GOODFIELD

State

Zip

61742

County

WOODFORD

Ever Disciplined

LastModifiedDate

05/02/2024