Avon Raissa Illao Fanco
ActiveCalifornia license 76797
License
- Licensed by
- Dental Board of California
- License number
- 76797
- Status
- Active (Current)
- First issued
- February 1, 2011
- Expires
- April 30, 2027
- License holder
- Avon Raissa Illao Fanco
- Entity type
- Individual
Classifications
- Registered Dental Assistant Dental
More from the license record
- License type code
- 4413
Contact
4237 Hamilton Ave Apt A
San Jose, CA 95130
San Jose, CA 95130
Santa Clara County