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Licensing details for: 82097

Name: WALTER JEFFERSON, DDS

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

11120 STOCKDALE HWY. SUITE 103
BAKERSFIELD CA 93311
KERN county
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Practice Location

11120 STOCKDALE HWY. SUITE 103
BAKERSFIELD CA 93311
KERN county
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Issuance Date

March 17, 2025

Expiration Date

July 31, 2026

Current Date / Time

June 7, 2025
3:44:58 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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