License holder summary

Jason David Roth is a Controlled Substance Registration-Physician Assistant licensed to practice in Indiana. The address on file for Jason David Roth is Ortho Indy, 8450 Northwest Blvd, Indianapolis IN 46278. This licensed professional license is current. The license was granted 09/28/2007 and expired on 06/30/2016.

Indiana

Professional Licensing Agency

Jason David Roth
Controlled Substance Registration-Physician Assistant
License number
10000474B
Date granted
09/28/2007
Date expires
06/30/2016
Class
Controlled Substance Registration-Physician Assistant
Status
Active
Address
Ortho Indy, 8450 Northwest Blvd, Indianapolis IN 46278
indianalicensing.org
ID 8387180
LAST UPDATED 2024-04-16 18:10:58 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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