Enty Tionowidjaja
ExpiredCalifornia license 37170
License
- Licensed by
- Dental Board of California
- License number
- 37170
- Status
- Expired (Delinquent)
- First issued
- April 17, 1989
- Expired
- August 31, 2023
- License holder
- Enty Tionowidjaja
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
PO Box 2001
La Habra, CA 90632-2001
La Habra, CA 90632-2001
Orange County