License holder summary

JACK Y FORMAN is a Dentist, Hygienist, Dental Assistant - Dentist licensed to practice in Michigan. The address on file for JACK Y FORMAN is Detroit, MI 48226. This licensed professional license is not current. The license was granted 07/18/1939 and expired on 08/31/1992.

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 2024-02-21 17:35:24 UTC

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