Dental Board of California
Licensing details for: 104485
Name: HENDRICKSON, RAYMOND HEATH
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by Credential
Previous Names: Hendrickson, Raymond Heath
Address of Record
2230 N University Pkwy
Suite 8A
PROVO UT 84604
UTAH county
Map
License Relationships
CS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Conscious Sedation Permit
Name: HENDRICKSON, RAYMOND HEATH
License/Registration Type: Conscious Sedation Permit
License Number: 1211 Primary Status: Cancelled
Address :
15951 Los Gatos Blvd
#8
LOS GATOS CA 95032-3428
MS to DDS or OMS or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Moderate Sedation Permit
Name: HENDRICKSON, RAYMOND HEATH
License/Registration Type: Moderate Sedation Permit
License Number: 439 Primary Status: Current - Active
Address :
15951 LOS GATOS BLVD, SUITE 8
LOS GATOS CA 95032
SANTA CLARA COUNTY
