JOHN WILLIAM ROTH Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

WILLIAM

Last Name

ROTH

Business Name

JOHN WILLIAM ROTH

Original Issue Date

07/19/2001

Effective Date

05/14/2019

Expiration Date

09/30/2020

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021