License Number: DN15387

Data As Of 2/6/2023

Profession Dentist
License DN15387
License Status CLEAR/ACTIVE
License Expiration Date 2/28/2024
License Original Issue Date 08/02/2000
Address of Record 3650 NW 82 AVE , SUITE 202
MIAMI, FL 33166
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain) Yes
Discipline on File No
Public Complaint No

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