Tania Agustina Lopez Fabian
ActiveCalifornia license 102507
License
- Licensed by
- Dental Board of California
- License number
- 102507
- Status
- Active (Current)
- First issued
- May 5, 2024
- Expires
- March 31, 2028
- License holder
- Tania Agustina Lopez Fabian
- Entity type
- Individual
Classifications
- Registered Dental Assistant Dental
More from the license record
- License type code
- 4413
Contact
2693 Anchor Ave
Port Hueneme, CA 93041
Port Hueneme, CA 93041
Ventura County