Dental Board of California
Licensing details for: 46346
Name: WILSON, RUSSELL CLAYTON
License Type: Dentist
Primary Status: Current - Active
Address of Record
7005 Atascadero Ave
ATASCADERO CA 93422-4431
SAN LUIS OBISPO county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: LAGUNA BEACH DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 2673 Primary Status: Cancelled
Address :
31796 S. COAST HIGHWAY
LAGUNA BEACH CA 92677
ORANGE 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: LAGUNA BEACH DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 2673 Primary Status: Cancelled
Address :
31796 S. COAST HIGHWAY
LAGUNA BEACH CA 92677
ORANGE COUNTY
