MICHAEL DONALD LASK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

ACTIVE

Business

First Name

MICHAEL

Middle

DONALD

Last Name

LASK

Business Name

MICHAEL DONALD LASK

Original Issue Date

06/25/2007

Effective Date

09/13/2024

Expiration Date

09/30/2027

City

VANDALIA

State

Zip

62471

County

FAYETTE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/13/2024