NEAL WALLACE ROLLER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****93

License Status

NOT RENEWED

Business

First Name

NEAL WALLACE

Last Name

ROLLER

Suffix

DDS

Business Name

NEAL WALLACE ROLLER DDS

Original Issue Date

08/12/1986

Effective Date

08/12/1986

Expiration Date

09/30/2006

City

EAST ALTON

State

Zip

62024

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006