DARREN JOSEPH ROTH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****57

License Status

NOT RENEWED

Business

First Name

DARREN

Middle

JOSEPH

Last Name

ROTH

Business Name

DARREN JOSEPH ROTH

Original Issue Date

03/23/2007

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

01/21/2009