NEAL WALLACE ROLLER DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013669

License Status

INACTIVE

Business

First Name

NEAL WALLACE

Last Name

ROLLER

Suffix

DDS

Business Name

NEAL WALLACE ROLLER DDS

Original Issue Date

07/14/1969

Effective Date

11/03/2021

Expiration Date

09/30/2024

City

GODFREY

State

Zip

62035

County

MADISON

Ever Disciplined

LastModifiedDate

05/01/2024