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Licensed Professional Information:
Dentist 2901601883


 

Licensee Detail

 
SPECIALTY CERTIFICATION

Specialty Certification:

Periodontics

Status:

Active

Issue Date:

09/13/2023

Expiration Date:

09/11/2026

CONTROLLED SUBSTANCE LIST

City:

ANN ARBOR

State or Province:

Michigan

ZIP or Postal Code:

48109-1078

CS Record Number:

5315244821

CS Status:

Active

CS Expiration Date:

09/11/2026

 
 

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