Dental Board of California
Licensing details for: 35475
Name: BOTTALA, JOHN ROBERT
License Type: Dentist
Primary Status: Current - Active
Address of Record
215 REBECCA DRIVE
SAN DIMAS CA 91773
LOS ANGELES 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: PREMIER DENTAL SPECIALTIES, DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 3832 Primary Status: Cancelled
Address :
2947 CHINO AVE
STE D3
CHINO HILLS CA 91709
SAN BERNARDINO COUNTY
