License holder summary

WAGGENER KELLY JOHANNA is a Dental License licensed to practice in California. The address on file for WAGGENER KELLY JOHANNA is 80 DOCTORS PARK DR SANTA ROSA CA 95405. This licensed professional license is current. The license was granted 04/16/2003 and expired on 04/30/2017.

California

Department of Consumer Affairs

WAGGENER KELLY JOHANNA
Dental License
License number
48404
Date granted
04/16/2003
Date expires
04/30/2017
Class
Dental License
Status
Current
Address
80 DOCTORS PARK DR SANTA ROSA CA 95405
californialicensing.org
ID 19803192
LAST UPDATED 2024-04-17 13:56:43 UTC

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