Kongsab La Hatlavongsa
ActiveCalifornia license 61581
License
- Licensed by
- Dental Board of California
- License number
- 61581
- Status
- Active (Current)
- First issued
- July 24, 2012
- Expires
- February 29, 2028
- License holder
- Kongsab La Hatlavongsa
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
445 11th St
Orange Cove, CA 93646-2211
Orange Cove, CA 93646-2211
Fresno County