Dental Board of California
Licensing details for: 61864
Name: SOMERVILLE, MATTHEW RYAN
License Type: Dentist
Primary Status: Current - Active
Secondary Status: Licensure by Residency
License Relationships
CS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Conscious Sedation Permit
Name: SOMERVILLE, MATTHEW RYAN
License/Registration Type: Conscious Sedation Permit
License Number: 1069 Primary Status: Cancelled
Address :
1240 S. Westlake Blvd
Ste 139
WESTLAKE VILLAGE CA 91361
VENTURA 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: SOMERVILLE, MATTHEW RYAN
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 2884 Primary Status: Cancelled
Address :
1240 S WESTLAKE BL
STE 139
WESTLAKE VILLAGE CA 91361
VENTURA COUNTY
