BRYAN MECKLER ROTH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064542

License Status

EXPIRED

Business

Title

First Name

BRYAN

Middle

MECKLER

Last Name

ROTH

Business Name

BRYAN MECKLER ROTH MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/04/2015