Form ID

Publication date

Location of premises

Certificate

Establish a New Dental Clinic

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Fort Malden Health Services
Address of Owner
201 Crown Ridge, Amherstburg, ON
Name of Contractor
Matrix Contractors
Address of Contractor
850 Talbot Rd., (Hwy. #3) Windsor, ON N9H 1A3

Identification of Premises

201 Crown Ridge Amherstburg ON