Dental Board of California
Licensing details for: 21921
Name: MILLER, RONALD WADE
License Type: Dentist
Primary Status: Cancelled
Secondary Status: Radiation Safety Certification issued by the Board
Address of Record
72 N HILL AVE
PASADENA CA 91106
LOS ANGELES county
Map
License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: RONALD W MILLER, DDS
License/Registration Type: Additional Office Permit
License Number: 5727 Primary Status: Cancelled
Address :
42-800 BOB HOPE DR STE 208
RANCHO MIRAGE CA 92270
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PASADENA PERIODONTICS AND IMPLANT DENTISTRY, DENTAL OFFICE OF MIL
License/Registration Type: Fictitious Name Permit
License Number: 11065 Primary Status: Cancelled
Address :
72 NORTH HILL AVENUE
PASADENA CA 91106
LOS ANGELES COUNTY
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: PASADENA PERIODONTICS AND IMPLANT DENTISTRY, DENTAL OFFICE OF MIL
License/Registration Type: Fictitious Name Permit
License Number: 11065 Primary Status: Cancelled
Address :
72 NORTH HILL AVENUE
PASADENA CA 91106
LOS ANGELES COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Oral Conscious Sedation Certificate
Name: MILLER, RONALD WADE
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 3308 Primary Status: Cancelled
Address :
72 N. HILL AVE
PASADENA CA 91106
LOS ANGELES COUNTY
