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Licensed Professional Information:
Medical Doctor 4301073023


 

Licensee Detail

 
CONTROLLED SUBSTANCE LIST

City:

Detroit

State or Province:

Michigan

ZIP or Postal Code:

48235

CS Record Number:

5315117913

CS Status:

Null & Void

CS Expiration Date:

06/30/2001

 

City:

Royal Oak

State or Province:

Michigan

ZIP or Postal Code:

48073

CS Record Number:

5315005194

CS Status:

Active

CS Expiration Date:

03/14/2026

 
 

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