NICHOLAS D DOLL Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****52

License Status

ACTIVE

Business

First Name

NICHOLAS

Middle

Last Name

DOLL

Business Name

NICHOLAS D DOLL

Original Issue Date

08/05/2014

Effective Date

08/13/2024

Expiration Date

09/30/2027

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/13/2024