Bassam Wisam Fargo
ActiveCalifornia license 101625
License
- Licensed by
- Dental Board of California
- License number
- 101625
- Status
- Active (Current)
- First issued
- July 21, 2017
- Expires
- January 31, 2027
- License holder
- Bassam Wisam Fargo
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
11559 Springwood Ct.
Riverside, CA 92505
Riverside, CA 92505
Riverside County