Hanny Susanto
ExpiredCalifornia license 39482
License
- Licensed by
- Dental Board of California
- License number
- 39482
- Status
- Expired (Delinquent)
- First issued
- July 26, 1991
- Expired
- April 30, 2023
- License holder
- Hanny Susanto
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
10226 Olive St.
Temple City, CA 91780
Temple City, CA 91780
Los Angeles County