ROTH EA DPM Podiatrist License verification

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000981

License Status

EXPIRED

Business

Title

DPM

First Name

ROTH

Last Name

Business Name

ROTH EA DPM

Original Issue Date

06/22/2017

Effective Date

07/01/2017

Expiration Date

07/01/2020

City

CHICAGO

State

Zip

60661

County

COOK

Ever Disciplined

LastModifiedDate

11/19/2020