KETTI RAE BOLLER DDS - Dentist License in Illinois | # 021002483

KETTI RAE BOLLER DDS

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021002483

License Status

ACTIVE

Business

N

Title

DDS

First Name

KETTI

Middle

RAE

Last Name

BOLLER

Business Name

KETTI RAE BOLLER DDS

Original Issue Date

08/24/2012

Effective Date

09/11/2024

Expiration Date

09/30/2027

State

IL

Specialty/Qualifier

ORTHODONTICS

Ever Disciplined

N

LastModifiedDate

10/07/2024