License holder summary

ROGER J FORMAN is a Dentist, Hygienist, Dental Assistant - Dentist licensed to practice in Michigan. The address on file for ROGER J FORMAN is Arvada, CO 80003. This licensed professional license is not current. The license was granted 06/12/1973 and expired on 08/31/1997.

Michigan

Department of Licensing and Regulation

ROGER J FORMAN
Dentist, Hygienist, Dental Assistant - Dentist
License number
2901010522
Date granted
06/12/1973
Date expires
08/31/1997
Class
Dentist, Hygienist, Dental Assistant - Dentist
Status
Lapsed
Address
Arvada, CO 80003
michiganlicensing.org
ID 25759308
LAST UPDATED 2024-04-19 16:55:06 UTC

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