KEVIN JOHN KELLERMAN DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

ACTIVE

Business

First Name

KEVIN

Middle

JOHN

Last Name

KELLERMAN

Suffix

DMD

Business Name

KEVIN JOHN KELLERMAN DMD

Original Issue Date

06/25/2002

Effective Date

05/03/2024

Expiration Date

09/30/2027

City

GLEN CARBON

State

Zip

62034

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/03/2024