License holder summary

DIPLOMATE OF THE AMERICAN BOARD OF PERIODONTOLOGY is a Dental - Registered Provider licensed to practice in California. The address on file for DIPLOMATE OF THE AMERICAN BOARD OF PERIODONTOLOGY is RANCHO CUCAMONGA. This licensed professional license is not current. The license was granted 03/20/1997 and expired on 03/20/1999.

California

Department of Consumer Affairs

DIPLOMATE OF THE AMERICAN BOARD OF PERIODONTOLOGY
Dental - Registered Provider
License number
3481
Date granted
03/20/1997
Date expires
03/20/1999
Class
Dental - Registered Provider
Status
Canceled
Address
RANCHO CUCAMONGA
californialicensing.org
ID 19813176
LAST UPDATED 2026-06-20 01:33:39 UTC

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