SYDNEY ROTH Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****67

License Status

ACTIVE

Business

First Name

SYDNEY

Last Name

ROTH

Business Name

SYDNEY ROTH

Original Issue Date

06/22/2023

Effective Date

01/27/2024

Expiration Date

03/01/2026

City

HAZEL CREST

State

Zip

60429

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025