Terry Wayne Forsberg
ExpiredCalifornia license 23605
License
- Licensed by
- Dental Board of California
- License number
- 23605
- Status
- Expired (Delinquent)
- First issued
- January 1, 1973
- Expired
- April 30, 2022
- License holder
- Terry Wayne Forsberg
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
2200 Mc Henry Ave.
Modesto, CA 95350
Modesto, CA 95350
Stanislaus County