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Licensed Professional Information:
Medical Doctor 4301055084


 
Note
Disciplinary Actions last updated on: 09/23/2025.
Condition: 
 Revoked Severity:  Notice
Total Conditions: 4  (Notice: 4)
 

Licensee Detail

 
CONTROLLED SUBSTANCE LIST

City:

Farmington Hills

State or Province:

Michigan

ZIP or Postal Code:

48331

CS Record Number:

5315095451

CS Status:

Lapsed - Suspended

CS Expiration Date:

09/12/2025

 

City:

farmington hills

State or Province:

Michigan

ZIP or Postal Code:

48331

CS Record Number:

5315112701

CS Status:

Lapsed

CS Expiration Date:

01/31/2013

 
 

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