DANA MARJORIE KOTH Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****44

License Status

ACTIVE

Business

First Name

DANA

Middle

MARJORIE

Last Name

KOTH

Business Name

DANA MARJORIE KOTH

Original Issue Date

07/31/2014

Effective Date

12/09/2025

Expiration Date

03/01/2028

City

GLENVIEW

State

Zip

60026

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/09/2025