California
Department of Consumer Affairs
HEALTHCARE QUALITY ASSURANCE
Dental - Registered Provider
License number
3005
Date granted
08/18/1992
Date expires
08/31/1994
Class
Dental - Registered Provider
Status
Canceled
Address
GUERNEVILLE
californialicensing.org
ID 19812242
LAST UPDATED 2026-04-22 00:12:20 UTC
LAST UPDATED 2026-04-22 00:12:20 UTC
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