DAVID WAYNE LUCKETT Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****03

License Status

NOT RENEWED

Business

First Name

DAVID WAYNE

Last Name

LUCKETT

Business Name

DAVID WAYNE LUCKETT

Original Issue Date

01/01/1998

Expiration Date

09/30/2002

City

LAWRENCEVILLE

State

Zip

62439

County

LAWRENCE

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/17/2005