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License Verification
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Data As Of 5/23/2013
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| Profession |
| DENTIST |
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| License/Activity Status |
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Controlled Substance Prescriber |
SUSPENDED/ACTIVE |
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NO |
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| License Expiration Date |
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License Original Issue Date |
| 2/28/2014 |
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07/19/1996 |
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| Discipline on File |
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Public Complaint |
YES
Link To Discipline
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YES
Link To Complaint
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| Address of Record |
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190 N HWY 17-92
SUITE 101
DEBARY,FL32713
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The information on this page is a secure, primary source for license verification provided by
The Florida Department of Health, Division of Medical Quality Assurance. This website is
maintained by Division staff and is updated immediately upon a change to our licensing and enforcement database.
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