Wallace R Blackwelder
ExpiredCalifornia license 31897
License
- Licensed by
- Dental Board of California
- License number
- 31897
- Status
- Expired (Delinquent)
- First issued
- August 1, 1983
- Expired
- June 30, 2026
- License holder
- Wallace R Blackwelder
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
19728 E Colima Rd
Rowland Heights, CA 91748
Rowland Heights, CA 91748
Los Angeles County