NEAL WALLACE ROLLER DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000879

License Status

INACTIVE

Business

First Name

NEAL WALLACE

Last Name

ROLLER

Suffix

DDS

Business Name

NEAL WALLACE ROLLER DDS

Original Issue Date

01/16/1976

Effective Date

01/16/1976

Expiration Date

09/30/2004

City

EAST ALTON

State

Zip

62024

County

MADISON

Specialty/Qualifier

Periodontics

Ever Disciplined

LastModifiedDate

10/17/2005