Dental Board of California
Licensing details for: 31395
Name: STEWART, WILBURN CARSON
License Type: Dentist
Primary Status: Voluntary Surrendered
Secondary Status: Prior Disciplinary Action
Address of Record
203 WALNUT STREET
POCOMORE MD 21851
WORCESTER county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: STEWART DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 2697 Primary Status: Cancelled
Address :
1518 NILES STREET
BAKERSFIELD CA 93305
KERN COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: BAKERSFIELD DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 1473 Primary Status: Cancelled
Address :
1518 NILES STREET
BAKERSFIELD CA 93306
KERN 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: BAKERSFIELD DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 1473 Primary Status: Cancelled
Address :
1518 NILES STREET
BAKERSFIELD CA 93306
KERN 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: STEWART DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 2697 Primary Status: Cancelled
Address :
1518 NILES STREET
BAKERSFIELD CA 93305
KERN COUNTY
