Dental Board of California
Licensing details for: 34834
Name: DIETRICH, MICHAEL BRIAN
License Type: Dentist
Primary Status: Cancelled
Address of Record
3439 BRIDGELAND DRIVE
BRIDGETON MO 63044
ST. LOUIS 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: DR. H.S. GILL'S DENTAL OFFICE
License/Registration Type: Fictitious Name Permit
License Number: 1176 Primary Status: Cancelled
Address :
14607 RAMONA BLVD, SUITE B
BALDWIN PARK CA 91706
LOS ANGELES COUNTY
