LEIGH DIANE ROTH - Physician Assistant License in Illinois | # 085003735

LEIGH DIANE ROTH

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003735

License Status

NOT RENEWED

Business

N

First Name

LEIGH

Middle

DIANE

Last Name

ROTH

Business Name

LEIGH DIANE ROTH

Original Issue Date

06/01/2010

Effective Date

02/26/2014

Expiration Date

03/01/2016

State

IL

Ever Disciplined

N

LastModifiedDate

04/25/2016