License holder summary

ROGER J FORMAN is a Dentistry - Dentist licensed to practice in Michigan. This medical licensee license is not current. The license was granted 06/12/1973 and expired on 08/31/1997.

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

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