ADAM ALEXANDER ROTH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074555

License Status

EXPIRED

Business

First Name

ADAM

Middle

ALEXANDER

Last Name

ROTH

Business Name

ADAM ALEXANDER ROTH

Original Issue Date

06/22/2019

Effective Date

06/22/2019

Expiration Date

06/21/2020

City

MAYWOOD

State

Zip

60153

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

11/19/2020