JESSICA CARYN ROTH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

Title

First Name

JESSICA

Middle

CARYN

Last Name

ROTH

Business Name

JESSICA CARYN ROTH MD

Original Issue Date

10/21/2016

Effective Date

10/21/2016

Expiration Date

07/31/2017

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017