ADAM CORGAN ROTH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008601

License Status

NOT RENEWED

Business

First Name

ADAM

Middle

CORGAN

Last Name

ROTH

Business Name

ADAM CORGAN ROTH

Original Issue Date

09/10/2021

Effective Date

09/10/2021

Expiration Date

03/01/2022

City

KALAMAZOO

State

Zip

49004

Ever Disciplined

LastModifiedDate

07/27/2022