MARY ANN ROTH Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010937

License Status

ACTIVE

Business

First Name

MARY

Middle

ANN

Last Name

ROTH

Business Name

MARY ANN ROTH

Original Issue Date

06/18/2004

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

NORMAL

State

Zip

61761

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/02/2024