California
Department of Consumer Affairs
DIVISION OF CLINICAL GENERAL DENTISTRY
Dental - Registered Provider
License number
3792
Date granted
12/28/1999
Date expires
12/31/2001
Class
Dental - Registered Provider
Status
Canceled
Address
SAN FRANCISCO
californialicensing.org
ID 19813595
LAST UPDATED 2026-05-17 09:51:10 UTC
LAST UPDATED 2026-05-17 09:51:10 UTC
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