NEAL WALLACE ROLLER DDS - Dentist License in Illinois | # 021000879

NEAL WALLACE ROLLER DDS

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000879

License Status

INACTIVE

Business

N

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

State

IL

Specialty/Qualifier

Periodontics

Ever Disciplined

N

LastModifiedDate

10/17/2005