License Number: DN21843

Data As Of 2/6/2023

Profession Dentist
License DN21843
License Status CLEAR/ACTIVE
License Expiration Date 2/28/2024
License Original Issue Date 05/31/2016
Address of Record 2000 NW 87th Ave STE 215
DORAL, FL 33172
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain) No
Discipline on File No
Public Complaint No

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