California
Department of Consumer Affairs
HEALTH PERSONNEL RESOURCES
Dental - Registered Provider
License number
4299
Date granted
04/28/2005
Date expires
04/30/2007
Class
Dental - Registered Provider
Status
Canceled
Address
ANDERSON
californialicensing.org
ID 19811552
LAST UPDATED 2026-06-27 16:44:17 UTC
LAST UPDATED 2026-06-27 16:44:17 UTC
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