AUSTIN DOUGLAS LACKE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

ACTIVE

Business

Title

DMD

First Name

AUSTIN

Middle

DOUGLAS

Last Name

LACKE

Business Name

AUSTIN DOUGLAS LACKE DMD

Original Issue Date

05/21/2021

Effective Date

09/10/2024

Expiration Date

09/30/2027

City

NAPERVILLE

State

Zip

60564

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/10/2024