MARK DALTON BOLLAERT DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****74

License Status

ACTIVE

Business

First Name

MARK

Middle

DALTON

Last Name

BOLLAERT

Suffix

DDS

Business Name

MARK DALTON BOLLAERT DDS

Original Issue Date

01/01/1998

Effective Date

07/19/2024

Expiration Date

09/30/2027

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/19/2024