MICHELLE L ROTH Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003057

License Status

ACTIVE

Business

First Name

MICHELLE

Middle

Last Name

ROTH

Business Name

MICHELLE L ROTH

Original Issue Date

09/19/2007

Effective Date

01/13/2026

Expiration Date

03/01/2028

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

01/13/2026