Dental Board of California

Licensing details for: 810

Name: VANDER KAM, NATALIE ANN

License Type: Oral Conscious Sedation

Primary Status: Cancelled

Specialty: Minor

Previous Names: POLON, NATALIE ANN

Address of Record

10393 TORRE AVENUE
SUITE L
CUPERTINO CA 95014
SANTA CLARA county
Map

Issuance Date

July 1, 2005

Expiration Date

September 30, 2013

Current Date / Time

June 6, 2025
10:35:22 AM

License/Registration Role: Oral Conscious Sedation Certificate

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: VANDER KAM, NATALIE ANN

License/Registration Type: Dentist License

License Number: 50347 Primary Status: Current - Active

Address :
620 California Blvd Ste H
SAN LUIS OBISPO CA 93401-2500
SAN LUIS OBISPO COUNTY