Licensee Name: | KING D'ET WALLACE |
License Type: | REGISTERED DENTAL HYGIENIST IN ALTERNATIVE PRACTICE |
License Number: | 81 |
License Status: | RENEWED/CURRENT Definition |
Expiration Date: | October 31, 2016 |
Issue Date: | January 06, 2005 |
County: | CONTRA COSTA |
Actions: | No |