KELLI J B BLANK DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019028666

License Status

ACTIVE

Business

First Name

KELLI J B

Last Name

BLANK

Suffix

DMD

Business Name

KELLI J B BLANK DMD

Original Issue Date

06/15/2011

Effective Date

09/19/2024

Expiration Date

09/30/2027

City

VANDALIA

State

Zip

62471

County

FAYETTE

Ever Disciplined

LastModifiedDate

09/19/2024