JACK KALLOCH DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****96

License Status

ACTIVE

Business

Title

DMD

First Name

JACK

Last Name

KALLOCH

Business Name

JACK KALLOCH DMD

Original Issue Date

09/11/2025

Effective Date

09/11/2025

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/11/2025