Hansel Darius Poerwanto
ActiveCalifornia license 100447
License
- Licensed by
- Dental Board of California
- License number
- 100447
- Status
- Active (Current)
- First issued
- July 16, 2016
- Expires
- April 30, 2027
- License holder
- Hansel Darius Poerwanto
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
P.O Box 78114
Stockton, CA 95267
Stockton, CA 95267
San Joaquin County