DEBORAH SUE ROTH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000074

License Status

NOT RENEWED

Business

First Name

DEBORAH SUE

Last Name

ROTH

Business Name

DEBORAH SUE ROTH

Original Issue Date

11/05/1980

Effective Date

11/05/1980

Expiration Date

11/05/1984

City

MORRIS

State

Zip

60450

County

GRUNDY

Ever Disciplined

LastModifiedDate

09/26/2006