Mavern Sermin Suprono
ExpiredCalifornia license 27842
License
- Licensed by
- Dental Board of California
- License number
- 27842
- Status
- Expired (Delinquent)
- First issued
- September 29, 1978
- Expired
- April 30, 2022
- License holder
- Mavern Sermin Suprono
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
P.O. Box 13218
San Bernardino, CA 92423
San Bernardino, CA 92423
San Bernardino County