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Licensed Professional Information:
Dentist 2901012411


 

Licensee Detail

 
CONTROLLED SUBSTANCE LIST

City:

Southfield

State or Province:

Michigan

ZIP or Postal Code:

48034

CS Record Number:

5315159868

CS Status:

Lapsed

CS Expiration Date:

06/30/1981

 

City:

Southfield

State or Province:

Michigan

ZIP or Postal Code:

48075

CS Record Number:

5315179091

CS Status:

Lapsed

CS Expiration Date:

08/31/2013

 

City:

Southfield

State or Province:

Michigan

ZIP or Postal Code:

48075

CS Record Number:

5315066952

CS Status:

Active

CS Expiration Date:

03/07/2023

 
 

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