NEAL WALLACE ROLLER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****92

License Status

NOT RENEWED

Business

First Name

NEAL WALLACE

Last Name

ROLLER

Suffix

DDS

Business Name

NEAL WALLACE ROLLER DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1994

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005