Department of Licensing and Regulatory Affairs
Board of Medicine
MELISA TIRTAPUTRA SUSANTO
Dentistry - Dentist Educational Limited
License number
2901020349
Date granted
03/02/2011
Date expires
08/31/2013
Class
Dentistry - Dentist Educational Limited
Status
Lapsed
Address
michiganmedical.net
ID 38909118
LAST UPDATED 2024-04-21 20:34:20 UTC
LAST UPDATED 2024-04-21 20:34:20 UTC
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