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Licensing details for: 334

Name: Borrero Fonseca, Maria Camila

License Type: Pediatric Minimal Sedation Permit

Primary Status: Current - Active

Previous Names: BORRERO, MARIA CAMILA BORRERO, CAMILA

Address of Record

569 W Lowell Ave
200
TRACY CA 95376-3081
SAN JOAQUIN county
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Practice Location

569 W Lowell Ave
200
TRACY CA 95376
SAN JOAQUIN county
Map

Issuance Date

August 20, 2024

Expiration Date

September 30, 2026

Current Date / Time

December 13, 2025
3:38:48 PM

License Relationships

PMS to DDS or OMS or SP

License/Registration Role: Pediatric Minimal Sedation Permit

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

Name: Borrero Fonseca, Maria Camila

License/Registration Type: Dentist License

License Number: 51046 Primary Status: Current - Active

Address :
569 W LOWELL AVE
STE 200
TRACY CA 95376
SAN JOAQUIN COUNTY

Map

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