ELISA MARIE ROTH DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021002648

License Status

ACTIVE

Business

First Name

ELISA

Middle

MARIE

Last Name

ROTH

Suffix

DMD

Business Name

ELISA MARIE ROTH DMD

Original Issue Date

03/11/2015

Effective Date

07/09/2024

Expiration Date

09/30/2027

City

MORTON

State

Zip

61550

Specialty/Qualifier

PEDIATRIC DENTISTRY

Ever Disciplined

LastModifiedDate

07/09/2024