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Licensing details for: 2771

Name: PRIETO, JORDAN DAVID

License Type: Oral Conscious Sedation

Primary Status: Cancelled

Specialty: Minor

Address of Record

7525 N Cedar Ave
105
FRESNO CA 93720
FRESNO county
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Practice Location

1900 Shaw Ave
101
1900 Shaw Ave, 101
CLOVIS CA 93611-4208
FRESNO county
Map

1900 Shaw Ave
101
CLOVIS CA 93611-4208
FRESNO county
Map

Issuance Date

August 2, 2012

Expiration Date

July 31, 2023

Current Date / Time

December 13, 2025
1:49:7 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: PRIETO, JORDAN DAVID

License/Registration Type: Dentist License

License Number: 61309 Primary Status: Current - Active

Address :
1900 Shaw Ave
101
CLOVIS CA 93611-4208
FRESNO COUNTY

Map

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