License holder summary

ALISA BASARA PHOENIX is a Dentistry - Dental Hygienist licensed to practice in Michigan. This medical licensee license is not current. The license was granted 01/27/1986 and expired on 08/31/1992.

Department of Licensing and Regulatory Affairs

Board of Medicine

ALISA BASARA PHOENIX
Dentistry - Dental Hygienist
License number
2902007711
Date granted
01/27/1986
Date expires
08/31/1992
Class
Dentistry - Dental Hygienist
Status
Lapsed
Address
michiganmedical.net
ID 38889581
LAST UPDATED 2024-03-18 23:31:14 UTC

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