| Licensee Name: | FAN OF DENTAL HYGIENE, PRACTICE OF ANDREW FAN, RDHAP |
| License Type: | FICTITIOUS NAME PERMIT |
| License Number: | 99 |
| License Status: | DELINQUENT Definition |
| Expiration Date: | December 31, 2012 |
| Issue Date: | June 27, 2012 |
| County: | SANTA CLARA |
| Actions: | No |