Department of Licensing and Regulatory Affairs
Board of Medicine
ROGER J FORMAN
Dentistry - Dentist
License number
2901010522
Date granted
06/12/1973
Date expires
08/31/1997
Class
Dentistry - Dentist
Status
Lapsed
Address
michiganmedical.net
ID 38898028
LAST UPDATED 2024-01-04 23:51:02 UTC
LAST UPDATED 2024-01-04 23:51:02 UTC
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