Lydia Koernianingsih
ActiveCalifornia license 48488
License
- Licensed by
- Dental Board of California
- License number
- 48488
- Status
- Active (Current)
- First issued
- October 10, 2001
- Expires
- July 31, 2028
- License holder
- Lydia Koernianingsih
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
1125 E 17th Street, Ste W234
Santa Ana, CA 92701
Santa Ana, CA 92701
Orange County