California
Department of Consumer Affairs
CALIFORNIA STATE MILITARY RESERVE
Dental - Registered Provider
License number
2363
Date granted
05/13/1988
Date expires
05/31/1990
Class
Dental - Registered Provider
Status
Canceled
Address
WESTLAKE VILLAGE
californialicensing.org
ID 19814346
LAST UPDATED 2026-06-22 13:03:08 UTC
LAST UPDATED 2026-06-22 13:03:08 UTC
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