ELLEN CLEARY BOLLMEIER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****95

License Status

NOT RENEWED

Business

Title

DMD

First Name

ELLEN

Middle

CLEARY

Last Name

BOLLMEIER

Business Name

ELLEN CLEARY BOLLMEIER DMD

Original Issue Date

01/27/1984

Effective Date

08/10/2012

Expiration Date

09/30/2015

City

SCOTT AIR FORCE BASE

State

Zip

62225

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016