SUSAN A ROTH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

ACTIVE

Business

First Name

SUSAN A

Last Name

ROTH

Suffix

Business Name

SUSAN A ROTH MD

Original Issue Date

10/22/1986

Effective Date

04/17/2023

Expiration Date

07/31/2026

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2023