KEVIN JOHN KELLERMAN DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000950

License Status

ACTIVE

Business

First Name

KEVIN

Middle

JOHN

Last Name

KELLERMAN

Suffix

DMD

Business Name

KEVIN JOHN KELLERMAN DMD

Original Issue Date

06/07/2016

Effective Date

05/03/2024

Expiration Date

09/30/2027

City

GLEN CARBON

State

Zip

62034

County

MADISON

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

05/03/2024