California
Department of Consumer Affairs
FORMAN PETER R
Dental License
License number
19065
Date granted
01/01/1966
Date expires
06/30/2013
Class
Dental License
Status
DELINQUENT, HOME OR MAILING ADDRESS
Address
P O BOX 254 DIABLO CA 94528
californialicensing.org
ID 19772962
LAST UPDATED 2026-04-21 14:00:54 UTC
LAST UPDATED 2026-04-21 14:00:54 UTC
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