An Duc Ta
ExpiredCalifornia license 103289
License
- Licensed by
- Dental Board of California
- License number
- 103289
- Status
- Expired (Delinquent)
- First issued
- September 29, 2018
- Expired
- August 31, 2023
- License holder
- An Duc Ta
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
606 Hillside Way
San Marcos, CA 92078-6004
San Marcos, CA 92078-6004
San Diego County