JOEL FORMAN DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013817

License Status

INACTIVE

Business

First Name

JOEL

Last Name

FORMAN

Suffix

DDS

Business Name

JOEL FORMAN DDS

Original Issue Date

07/07/1970

Effective Date

07/07/1970

Expiration Date

09/30/1994

City

SOUTHFIELD

State

Zip

48075

County

MICHIGAN

Ever Disciplined

LastModifiedDate

10/12/2005