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Licensed Professional Information:
Dentist 2901021034


 
Note
Disciplinary Actions last updated on: 10/19/2020.
Condition: 
Suspended Severity:  Notice
Total Conditions: 6  (Notice: 6)
 

Licensee Detail

 
CONTROLLED SUBSTANCE LIST

City:

Grandville

State or Province:

Michigan

ZIP or Postal Code:

49418

CS Record Number:

5315061530

CS Status:

Active

CS Expiration Date:

06/20/2027

 
 

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