KELLEN N BOSMA DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****57

License Status

ACTIVE

Business

Title

DMD

First Name

KELLEN

Middle

Last Name

BOSMA

Business Name

KELLEN N BOSMA DMD

Original Issue Date

07/12/2013

Effective Date

09/30/2024

Expiration Date

09/30/2027

City

SYCAMORE

State

Zip

60178

County

DEKALB

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/30/2024