License holder summary

JACK Y FORMAN is a Dentistry - Dentist licensed to practice in Michigan. This medical licensee license is not current. The license was granted 07/18/1939 and expired on 08/31/1992.

Department of Licensing and Regulatory Affairs

Board of Medicine

JACK Y FORMAN
Dentistry - Dentist
License number
2901004851
Date granted
07/18/1939
Date expires
08/31/1992
Class
Dentistry - Dentist
Status
Lapsed
Address
michiganmedical.net
ID 38898026
LAST UPDATED 2024-04-01 08:35:49 UTC

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