California
Department of Consumer Affairs
TIMOTHY E. MICKIEWICK, DDS
Dental - Registered Provider
License number
4111
Date granted
08/12/2003
Date expires
08/31/2007
Class
Dental - Registered Provider
Status
Canceled
Address
SACRAMENTO
californialicensing.org
ID 19813407
LAST UPDATED 2024-04-18 20:35:03 UTC
LAST UPDATED 2024-04-18 20:35:03 UTC
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