KATHLEEN MARIE LUCKING Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****63

License Status

ACTIVE

Business

First Name

KATHLEEN

Middle

MARIE

Last Name

LUCKING

Business Name

KATHLEEN MARIE LUCKING

Original Issue Date

06/17/2013

Effective Date

09/17/2024

Expiration Date

09/30/2027

City

URBANA

State

Zip

61802

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/17/2024