TOM D KELLER - Dentist License in Illinois | # 018001054

TOM D KELLER

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001054

License Status

NOT RENEWED

Business

N

First Name

TOM

Middle

D

Last Name

KELLER

Business Name

TOM D KELLER

Original Issue Date

07/21/1997

Effective Date

07/21/1997

Expiration Date

06/30/1999

State

IL

Specialty/Qualifier

Pediatric Dentist

Ever Disciplined

N

LastModifiedDate

07/30/2018