PAUL BRYAN ROACH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

ACTIVE

Business

First Name

PAUL

Middle

BRYAN

Last Name

ROACH

Suffix

Business Name

PAUL BRYAN ROACH MD

Original Issue Date

12/10/2013

Effective Date

05/19/2023

Expiration Date

07/31/2026

City

FOREST PARK

State

Zip

60130

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/19/2023