California
Department of Consumer Affairs
FORMAN RICHARD MICHAEL
Dental License
License number
30956
Date granted
07/14/1982
Date expires
06/30/2013
Class
Dental License
Status
DELINQUENT, SELF EMPLOYED AT 1 LOCATION
Address
252 S. CANON DR. BEVERLY HILLS CA 90212
californialicensing.org
ID 19768302
LAST UPDATED 2026-07-05 04:04:05 UTC
LAST UPDATED 2026-07-05 04:04:05 UTC
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