Dental Board of California
Licensing details for: 949
Name: DOUGLAS, SHANE MARK
License Type: Conscious Sedation
Primary Status: Cancelled
Previous Names: DOUGLAS, SHANE M
Address of Record
3700 ATHERTON ROAD
ROCKLIN CA 95765
PLACER county
Map
License Relationships
CS to DDS, OMS, or SP
License/Registration Role: Conscious Sedation Permit
Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Name: DOUGLAS, SHANE MARK
License/Registration Type: Dentist License
License Number: 61439 Primary Status: Current - Active
Address :
3700 ATHERTON RD
ROCKLIN CA 95765
PLACER COUNTY
