California
Department of Consumer Affairs
COASTLINE ROP
Dental - Registered Provider
License number
5331
Date granted
06/02/2014
Date expires
06/30/2016
Class
Dental - Registered Provider
Status
Current
Address
COSTA MESA
californialicensing.org
ID 19811899
LAST UPDATED 2026-05-01 23:18:26 UTC
LAST UPDATED 2026-05-01 23:18:26 UTC
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