Damita Dora Wiredja
ActiveCalifornia license 106565
License
- Licensed by
- Dental Board of California
- License number
- 106565
- Status
- Active (Current)
- First issued
- July 13, 2021
- Expires
- May 31, 2028
- License holder
- Damita Dora Wiredja
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
6100 Atlantic Blvd. Suite I
Maywood, CA 90270
Maywood, CA 90270
Los Angeles County