License Number: DN20614

Data As Of 3/1/2024

Profession Dentist
License DN20614
License Status CLEAR/ACTIVE
License Expiration Date 2/28/2026
License Original Issue Date 05/30/2014
Address of Record 2989 ALAFAYA TRAIL
OVIEDO, FL 32765
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain) Yes
Discipline on File No
Public Complaint No

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