TODD A STOLLER DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****69

License Status

ACTIVE

Business

First Name

TODD A

Last Name

STOLLER

Suffix

DDS

Business Name

TODD A STOLLER DDS

Original Issue Date

09/05/1991

Effective Date

08/01/2024

Expiration Date

09/30/2027

City

PEKIN

State

Zip

61554

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/01/2024