STEPHEN NATHAN ROTH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

ACTIVE

Business

First Name

STEPHEN

Middle

NATHAN

Last Name

ROTH

Suffix

Business Name

STEPHEN NATHAN ROTH MD

Original Issue Date

12/01/1999

Effective Date

06/02/2023

Expiration Date

07/31/2026

City

LAKE FOREST

State

Zip

60045

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/02/2023