PATRICIA KAY LACKOVICH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020005108

License Status

NOT RENEWED

Business

First Name

PATRICIA KAY

Last Name

LACKOVICH

Business Name

PATRICIA KAY LACKOVICH

Original Issue Date

01/17/1983

Effective Date

01/17/1983

Expiration Date

09/30/1984

City

RACINE

State

Zip

53406

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/12/2005