Dental Board of California
Licensing details for: 109006
Name: LA, CASEY
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by ADEX
Address of Record
6348 Mission Blvd
106
JURUPA VALLEY CA 92509
RIVERSIDE county
Map
License Relationships
FNP to DDS or OMS
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Fictitious Name Permit
Name: Jurupa Valley Dental Group, Jurupa Valley Dental Group, Inc.
License/Registration Type: Fictitious Name Permit
License Number: 20473 Primary Status: Current - Active
Address :
6348 Mission Blvd., Unit 105
JURUPA VALLEY CA 92509
