Mandalene Jayne Mirkhah
ExpiredCalifornia license 104499
License
- Licensed by
- Dental Board of California
- License number
- 104499
- Status
- Expired (Delinquent)
- First issued
- October 23, 2019
- Expired
- August 31, 2022
- License holder
- Mandalene Jayne Mirkhah
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
717 West Glendale Avenue
Phoenix, AZ 85021
Phoenix, AZ 85021
Maricopa County