JASON E ROACH Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****60

License Status

ACTIVE

Business

First Name

JASON

Middle

Last Name

ROACH

Business Name

JASON E ROACH

Original Issue Date

11/26/2012

Effective Date

12/03/2025

Expiration Date

03/01/2028

City

EUREKA

State

Zip

61530

County

MCLEAN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025