License holder summary

SPEECH SOURCE-SPEECH/LANGUAGE PATHOLOGY is a Dental - Registered Provider licensed to practice in California. The address on file for SPEECH SOURCE-SPEECH/LANGUAGE PATHOLOGY is ENCINO. This licensed professional license is not current. The license was granted 05/16/2007 and expired on 05/31/2013.

California

Department of Consumer Affairs

SPEECH SOURCE-SPEECH/LANGUAGE PATHOLOGY
Dental - Registered Provider
License number
4522
Date granted
05/16/2007
Date expires
05/31/2013
Class
Dental - Registered Provider
Status
Delinquent
Address
ENCINO
californialicensing.org
ID 19812052
LAST UPDATED 2024-03-07 16:03:40 UTC

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