Samuel Evan Dastrup
ExpiredCalifornia license 104442
License
- Licensed by
- Dental Board of California
- License number
- 104442
- Status
- Expired (Delinquent)
- First issued
- September 20, 2019
- Expired
- September 30, 2025
- License holder
- Samuel Evan Dastrup
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
345 Trinity Ave
Chowchilla, CA 93610-2860
Chowchilla, CA 93610-2860
Merced County