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Licensed Professional Information:
Dentist 2901021727


 

Licensee Detail

 
CONTROLLED SUBSTANCE LIST

City:

Detroit

State or Province:

Michigan

ZIP or Postal Code:

48221

CS Record Number:

5315073241

CS Status:

Lapsed

CS Expiration Date:

08/31/2019

 

City:

Monroe

State or Province:

Michigan

ZIP or Postal Code:

48162

CS Record Number:

5315227863

CS Status:

Lapsed

CS Expiration Date:

08/09/2024

 

City:

Dearborn

State or Province:

Michigan

ZIP or Postal Code:

48126

CS Record Number:

5315259851

CS Status:

Active

CS Expiration Date:

07/30/2028

DRUG CONTROL LIST

City:

Monroe

State:

Michigan

ZIP Code:

48162

DC Record Number:

5307011011

DC Status:

Lapsed

DC Expiration Date:

08/09/2024

 
 

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