VIVIAN ROTH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036026514

License Status

NOT RENEWED

Business

First Name

VIVIAN

Last Name

ROTH

Suffix

Business Name

VIVIAN ROTH MD

Original Issue Date

11/16/1945

Effective Date

11/16/1945

City

GREENPORT L I

State

Zip

11944

County

NEW YORK

Ever Disciplined

LastModifiedDate

09/20/2006