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Licensing details for: 3904

Name: SHRIVER, NENI DIAH

License Type: Oral Conscious Sedation

Primary Status: Cancelled

Specialty: Minor

Address of Record

7817 IVANHOE AVENUE #304
LA JOLLA CA 92037
SAN DIEGO county
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Practice Location

7817 Ivanhoe Ave Ste 304
LA JOLLA CA 92037-4555
SAN DIEGO county
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Issuance Date

May 23, 2019

Expiration Date

October 31, 2022

Current Date / Time

June 6, 2025
8:18:24 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: SHRIVER, NENI DIAH

License/Registration Type: Dentist License

License Number: 45194 Primary Status: Current - Active

Address :
7817 Ivanhoe Ave. Ste.304
LA JOLLA CA 92037
SAN DIEGO COUNTY

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