Dental Board of California
Licensing details for: 2075
Name: JEFFERSON, WALTER
License Type: Oral Conscious Sedation
Primary Status: Cancelled
Specialty: Adult
Address of Record
16475 SIERRA LAKES PKWY
FONTANA CA 92336
SAN BERNARDINO county
Map
License Relationships
OCS to DDS, OMS, or SP
License/Registration Role: Oral Conscious Sedation Certificate
Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Name: JEFFERSON, WALTER
License/Registration Type: Dentist License
License Number: 53460 Primary Status: Current - Active
Address :
16475 SIERRA LAKES PKWY
STE 140
FONTANA CA 92336
SAN BERNARDINO COUNTY
