LUKE WILLIAM REVELT DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****95

License Status

ACTIVE

Business

Title

DMD

First Name

LUKE

Middle

WILLIAM

Last Name

REVELT

Business Name

LUKE WILLIAM REVELT DMD

Original Issue Date

11/24/2020

Effective Date

09/22/2024

Expiration Date

09/30/2027

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/22/2024