California
Department of Consumer Affairs
LAKSMANA THERESIA SIANITA
Dental License
License number
58149
Date granted
03/24/2009
Date expires
10/31/2017
Class
Dental License
Status
Current
Address
12035 LUCILE STREET CULVER CITY CA 90230
californialicensing.org
ID 19772202
LAST UPDATED 2026-05-26 23:37:27 UTC
LAST UPDATED 2026-05-26 23:37:27 UTC
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