KELLY ANN ROTH Orthotist, Prosthetist, and Pedorthist License verification

Business Entity

ACTIVE

License Type

Orthotist, Prosthetist, and Pedorthist

Description

LICENSED ORTHOTIST

License Number

213000351

License Status

ACTIVE

Business

First Name

KELLY

Middle

ANN

Last Name

ROTH

Business Name

KELLY ANN ROTH

Original Issue Date

12/07/2016

Effective Date

01/23/2026

Expiration Date

09/30/2027

City

CROWN POINT

State

Zip

46307

County

LAKE

Ever Disciplined

LastModifiedDate

01/23/2026