JACOB Xavier PHEN
ActiveCalifornia license 107806
License
- Licensed by
- Dental Board of California
- License number
- 107806
- Status
- Active (Current)
- First issued
- August 17, 2022
- Expires
- January 31, 2027
- License holder
- JACOB Xavier PHEN
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
850 W March Ln Ste B
Stockton, CA 95207-6207
Stockton, CA 95207-6207
San Joaquin County