Justin Mikkel Tan
InactiveCalifornia license 64052
License
- Licensed by
- Dental Board of California
- License number
- 64052
- Status
- Inactive (CurrentInactive)
- First issued
- September 5, 2014
- Expires
- November 30, 2026
- License holder
- Justin Mikkel Tan
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
17205 NE 27th Ave
Ridgefield, WA 98642
Ridgefield, WA 98642
Clark County