DALE AROLD COLLER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036103296

License Status

NOT RENEWED

Business

First Name

DALE

Middle

AROLD

Last Name

COLLER

Business Name

DALE AROLD COLLER

Original Issue Date

08/18/2000

Effective Date

08/18/2000

Expiration Date

07/31/2005

City

LA GRANGE

State

Zip

60525

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006