NANCY B HOLLER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****79

License Status

NOT RENEWED

Business

First Name

NANCY B

Last Name

HOLLER

Suffix

DDS

Business Name

NANCY B HOLLER DDS

Original Issue Date

06/06/1997

Effective Date

06/06/1997

Expiration Date

09/30/2000

City

DECATUR

State

Zip

62526

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005