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Licensed Professional Information:
Osteopathic Physician 5101021157


 

Licensee Detail

 
CONTROLLED SUBSTANCE LIST

City:

Garden City

State or Province:

Michigan

ZIP or Postal Code:

48135

CS Record Number:

5315065766

CS Status:

Lapsed

CS Expiration Date:

06/30/2017

 

City:

Bloomfield hills

State or Province:

Michigan

ZIP or Postal Code:

48301

CS Record Number:

5315080043

CS Status:

Active

CS Expiration Date:

02/06/2027

 
 

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