California
Department of Consumer Affairs
THE INSTITUTE FOR GOVERNMENT AFFAIRS & PUBLIC
Dental - Registered Provider
License number
4003
Date granted
05/28/2002
Date expires
05/31/2004
Class
Dental - Registered Provider
Status
Canceled
Address
SACRAMENTO
californialicensing.org
ID 19813404
LAST UPDATED 2026-04-13 06:37:54 UTC
LAST UPDATED 2026-04-13 06:37:54 UTC
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