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Licensing details for: 2740

Name: MATTSON, VIRGINIA PADUA

License Type: Oral Conscious Sedation

Primary Status: Expired Primary Status Definition

Specialty: Adult

Previous Names: BARAN, VIRGINIA PADUA

Address of Record

11717 BERNARDO PLAZA CT
SUITE 100
SAN DIEGO CA 92128
SAN DIEGO county
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Practice Location

11717 Bernardo Plaza Court
Suite 100
SAN DIEGO CA 92128
SAN DIEGO county
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Issuance Date

April 9, 2012

Expiration Date

February 28, 2025

Current Date / Time

June 6, 2025
8:42:30 PM

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: MATTSON, VIRGINIA PADUA

License/Registration Type: Dentist License

License Number: 41350 Primary Status: Current - Active

Address :
11717 Bernardo Plaza Ct
SUITE 100
SAN DIEGO CA 92128-2412
SAN DIEGO COUNTY

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