Blake Albert La Bounty
ExpiredCalifornia license 48627
License
- Licensed by
- Dental Board of California
- License number
- 48627
- Status
- Expired (Delinquent)
- First issued
- August 15, 2001
- Expired
- August 31, 2022
- License holder
- Blake Albert La Bounty
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
10745 Pinon Ave
Morongo Valley, CA 92256-9297
Morongo Valley, CA 92256-9297
San Bernardino County