License Number: ME59827

Data As Of 7/10/2020

Profession Medical Doctor
License ME59827
License Status CLEAR/ACTIVE
License Expiration Date 1/31/2022
License Original Issue Date 04/30/1991
Address of Record 7902 NW 36TH STREET
SUITE #202
MIAMI, FL 33166
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain) Yes
Discipline on File No
Public Complaint No

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