KETTI RAE BOLLER DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019029042

License Status

ACTIVE

Business

Title

DDS

First Name

KETTI

Middle

RAE

Last Name

BOLLER

Business Name

KETTI RAE BOLLER DDS

Original Issue Date

06/08/2012

Effective Date

09/11/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

10/07/2024