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Licensed Professional Information:
Dentist 2901012253


 
Note
Disciplinary Actions last updated on: 05/03/2019.
Condition: 
Probation Severity:  Notice
Total Conditions: 3  (Notice: 3)
 

Licensee Detail

 
CONTROLLED SUBSTANCE LIST

City:

Webberville

State or Province:

Michigan

ZIP or Postal Code:

48892

CS Record Number:

5315192386

CS Status:

Lapsed

CS Expiration Date:

06/20/2024

 
 

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