DYLAN DWIGHT ROTH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125086943

License Status

ACTIVE

Business

Title

First Name

DYLAN

Middle

DWIGHT

Last Name

ROTH

Business Name

DYLAN DWIGHT ROTH MD

Original Issue Date

06/26/2025

Effective Date

06/26/2025

Expiration Date

06/25/2028

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

04/30/2025