Dental Board of California
Licensing details for: 2413
Name: REYES, RAQUEL REQUILMAN
License Type: Oral Conscious Sedation
Primary Status: Expired
Specialty: Adult
Address of Record
8590 Rio San Diego Dr Ste 110
SAN DIEGO CA 92108-5597
SAN DIEGO county
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License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: RIO VISTA FAMILY DENTISTRY, DENTAL OFFICE,
License/Registration Type: Fictitious Name Permit
License Number: 5160 Primary Status: Expired
Address :
8590 RIO SAN DIEGO DR, STE 110
SAN DIEGO CA 92108
SAN DIEGO COUNTY
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: REYES, RAQUEL REQUILMAN
License/Registration Type: Dentist License
License Number: 51516 Primary Status: Current - Active
Address :
8590 Rio San Diego Dr Ste 110
SAN DIEGO CA 92108-5597
SAN DIEGO COUNTY
