License holder summary

MODESTO MAXILLOFACIAL RADIOLOGY is a Dental - Registered Provider licensed to practice in California. The address on file for MODESTO MAXILLOFACIAL RADIOLOGY is MODESTO. This licensed professional license is not current. The license was granted 12/04/2007 and expired on 12/31/2011.

California

Department of Consumer Affairs

MODESTO MAXILLOFACIAL RADIOLOGY
Dental - Registered Provider
License number
4580
Date granted
12/04/2007
Date expires
12/31/2011
Class
Dental - Registered Provider
Status
Delinquent
Address
MODESTO
californialicensing.org
ID 19812757
LAST UPDATED 2026-05-10 12:33:36 UTC

This website is unaffiliated with the Department of Consumer Affairs. Please verify all information directly with the relevant official government authority.

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