In an exacerbated attempt to get it working, the directory that I have the extension dlls in, was given full access by everyone.
IIS Authentication shouldn't matter, because PHP is compiled outside of the server environment. And like I said, I had already compiled the GD Libraries into my build of PHP.
It's quite possible that I'm simply just missing a step. If the ldap libraries included with php (php_ldap.dll) and the dlls in the 'dll' folder. (Places in my System32 folder). I uncommented the extension line and added the --with-ldap switch to my .ini file.
The biggest kick in the pants is that, just for fun, I loaded all the extensions in the directory. About half of them got the 'Access Denied' error, while the other half compiled succesfully. And bear in mind that they all have the same permissions on the files.
Any Ideas?