DAVID E ROTH MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036124236

License Status

INACTIVE

Business

First Name

DAVID

Middle

Last Name

ROTH

Suffix

Business Name

DAVID E ROTH MD

Original Issue Date

08/17/2009

Effective Date

06/13/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

04/12/2017