Arathai Ballie Pich Phongsavanh
ActiveCalifornia license 104659
License
- Licensed by
- Dental Board of California
- License number
- 104659
- Status
- Active (Current)
- First issued
- April 3, 2025
- Expires
- August 31, 2028
- License holder
- Arathai Ballie Pich Phongsavanh
- Entity type
- Individual
Classifications
- Registered Dental Assistant Dental
More from the license record
- License type code
- 4413
Contact
2827 Del Rio Dr
Stockton, CA 95204-1431
Stockton, CA 95204-1431
San Joaquin County