LISA MARIE BOLAND DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****76

License Status

NOT RENEWED

Business

First Name

LISA MARIE

Last Name

BOLAND

Suffix

DMD

Business Name

LISA MARIE BOLAND DMD

Original Issue Date

09/22/1997

Effective Date

09/22/1997

Expiration Date

09/30/2004

City

ELMHURST

State

Zip

60126

County

DUPAGE

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/17/2005