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Licensed Professional Information:
Medical Doctor 4301069256


 
Note
Disciplinary Actions last updated on: 05/03/2019.
Condition: 
 Fine Imposed Severity:  Notice
Total Conditions: 1  (Notice: 1)
 

Licensee Detail

 
CONTROLLED SUBSTANCE LIST

City:

Dearborn

State or Province:

Michigan

ZIP or Postal Code:

48124

CS Record Number:

5315102744

CS Status:

Active

CS Expiration Date:

05/13/2027

 

City:

Plymouth

State or Province:

Michigan

ZIP or Postal Code:

48170

CS Record Number:

5315197678

CS Status:

Lapsed

CS Expiration Date:

08/31/1999

 
 

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