ERLO ROTH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

ERLO

Last Name

ROTH

Suffix

Business Name

ERLO ROTH MD

Original Issue Date

10/08/2015

Effective Date

04/26/2017

Expiration Date

09/30/2020

City

SAINT CHARLES

State

Zip

60174

County

KANE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021