California
Department of Consumer Affairs
DEPT OF PUBLIC HEALTH DENTAL BUREAU
Dental - Registered Provider
License number
3559
Date granted
09/16/1997
Date expires
09/30/2013
Class
Dental - Registered Provider
Status
Delinquent
Address
SAN FRANCISCO
californialicensing.org
ID 19813594
LAST UPDATED 2026-06-11 14:32:30 UTC
LAST UPDATED 2026-06-11 14:32:30 UTC
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