KENNETH SCOTT KOLLMANN Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000555

License Status

INACTIVE

Business

First Name

KENNETH SCOTT

Last Name

KOLLMANN

Business Name

KENNETH SCOTT KOLLMANN

Original Issue Date

04/26/2002

Effective Date

07/21/2015

Expiration Date

09/30/2018

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

06/07/2018