Montry Selin Suprono
ActiveCalifornia license 56324
License
- Licensed by
- Dental Board of California
- License number
- 56324
- Status
- Active (Current)
- First issued
- September 5, 2007
- Expires
- July 31, 2027
- License holder
- Montry Selin Suprono
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
11487 Via Capri
Loma Linda, CA 92354-3853
Loma Linda, CA 92354-3853
San Bernardino County