MICHAEL A LUCKETT DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****35

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

LUCKETT

Suffix

DMD

Business Name

MICHAEL A LUCKETT DMD

Original Issue Date

08/09/1999

Effective Date

08/31/2009

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60636

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012