Dallas Dominique Johnston
ActiveMichigan license 5601011845
License
- Licensed by
- Michigan Department of Licensing and Regulatory Affairs
- License number
- 5601011845
- Status
- Active
- First issued
- July 20, 2023
- Expires
- July 20, 2028
- License holder
- Dallas Dominique Johnston
- Entity type
- Individual
Classifications
- Physicians Assistant Physicians & Surgeons
Contact
100 Michigan St NE
Mc 019
Grand Rapids, MI 49503
Mc 019
Grand Rapids, MI 49503
Kent County