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Licensing details for: 4107

Name: CLARK, ANTHONY AARON

License Type: Oral Conscious Sedation

Primary Status: Expired Primary Status Definition

Specialty: Adult

Address of Record

474 Hampton St
TULARE CA 93274-7516
TULARE county
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Practice Location

535 S Akers St
VISALIA CA 93291
TULARE county
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Issuance Date

January 25, 2021

Expiration Date

November 30, 2023

Current Date / Time

June 6, 2025
2:17:30 AM

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: CLARK, ANTHONY AARON

License/Registration Type: Dentist License

License Number: 102890 Primary Status: Current - Active

Address :
535 N Akers St
VISALIA CA 93291-5173
TULARE COUNTY

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