CHARLEEN J LAKE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****31

License Status

NOT RENEWED

Business

First Name

CHARLEEN J

Last Name

LAKE

Suffix

DDS

Business Name

CHARLEEN J LAKE DDS

Original Issue Date

01/01/1998

Effective Date

09/24/2018

Expiration Date

01/31/2022

City

WESTMONT

State

Zip

60559

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022