Jiravat Wangwongvivat
ActiveCalifornia license 40201
License
- Licensed by
- Dental Board of California
- License number
- 40201
- Status
- Active (Current)
- First issued
- August 14, 1992
- Expires
- January 31, 2028
- License holder
- Jiravat Wangwongvivat
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
12724 Sherman Way
North Hollywood, CA 91605
North Hollywood, CA 91605
Los Angeles County