Mallory Kaye Russell
ActiveCalifornia license 104077
License
- Licensed by
- Dental Board of California
- License number
- 104077
- Status
- Active (Current)
- First issued
- July 18, 2019
- Expires
- July 31, 2028
- License holder
- Mallory Kaye Russell
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
4713 W 137th Pl
Hawthorne, CA 90250-6807
Hawthorne, CA 90250-6807
Los Angeles County