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Licensing details for: 10880

Name: JEFFERSON AND LAMBRIDIS DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Secondary Status: Cancelled at the Request of the LicenseePrimary Status Definition

Address of Record

5353 Gosford Rd
BAKERSFIELD CA 93313-4958
KERN county
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Practice Location

5353 GOSFORD ROAD, SUITE 103
BAKERSFIELD CA 93313
KERN county
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Issuance Date

December 19, 2012

Expiration Date

July 31, 2018

Current Date / Time

June 6, 2025
10:18:28 AM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

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

Name: JEFFERSON, WALTER

License/Registration Type: Dentist License

License Number: 53460 Primary Status: Current - Active

Address :
16475 SIERRA LAKES PKWY
STE 140
FONTANA CA 92336
SAN BERNARDINO COUNTY

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