ZACHARY JOSEPH KELLER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****12

License Status

NOT RENEWED

Business

Title

DMD

First Name

ZACHARY

Middle

JOSEPH

Last Name

KELLER

Business Name

ZACHARY JOSEPH KELLER DMD

Original Issue Date

04/03/2017

Effective Date

04/03/2017

Expiration Date

09/30/2018

City

GLEN CARBON

State

Zip

62034

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/31/2018