| Certificate Number | 15293 | ||
| Class | Full | From May 14, 2016 | |
| Class History | Grandparented | From May 13, 2016 | |
| Status | In good standing | From May 13, 2016 | |
| Restrictions/Disciplines | No | ||
| First Name | Gary |
| Middle Name | Allen |
| Last Name | Fortinsky |
| Alternate Name |
| Professional Body Name | Country | Region |
|---|---|---|
| Royal College of Dental Surgeons of Ontario | Canada | Ontario |
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