Michigan
Department of Licensing and Regulation
JACK Y FORMAN
Dentist, Hygienist, Dental Assistant - Dentist
License number
2901004851
Date granted
07/18/1939
Date expires
08/31/1992
Class
Dentist, Hygienist, Dental Assistant - Dentist
Status
Lapsed
Address
Detroit, MI 48226
michiganlicensing.org
ID 25759309
LAST UPDATED 2024-03-27 20:38:40 UTC
LAST UPDATED 2024-03-27 20:38:40 UTC
This website is unaffiliated with the Department of Licensing and Regulation. Please verify all information directly with the relevant official government authority.