Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Oct 16, 2011
License(s)
5302037550 (MI), 28ri03433400 (NJ)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 7010 CHIMNEY HILL DR APT # 3104 | West Bloomfield, MI 48322-4548 | |
| LOCATION | 7380 ORCHARD LAKE RD | West Bloomfield, MI 48322-3621 | 248-538-8373 |
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