Theresia Sianita Laksmana
ActiveCalifornia license 58149
License
- Licensed by
- Dental Board of California
- License number
- 58149
- Status
- Active (Current)
- First issued
- March 24, 2009
- Expires
- October 31, 2027
- License holder
- Theresia Sianita Laksmana
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
1448 S San Gabriel Blvd
San Gabriel, CA 91776-3656
San Gabriel, CA 91776-3656
Los Angeles County