California Veterinary Medical Board
Licensing details for: 12115
Name: MAGNUSSEN, KIPP L
License Type: Veterinarian
Primary Status: Current
Previous Names: MAGNUSSEN, KIPP L DVM
Address of Record
1520 Standiford Ave
MODESTO CA 95350-0568
STANISLAUS county
Map
License Relationships
Premises to Managing Licensee
License/Registration Role: Veterinarian
Related Party Role: Veterinary Premises
Name: SYLVAN VETERINARY HOSPITAL, INC
License/Registration Type: Veterinary Premises
License Number: 1651 Primary Status: Cancelled
Address :
3520 Roselle Ave
MODESTO CA 95357-1632
STANISLAUS COUNTY
Premises to Managing Licensee
License/Registration Role: Veterinarian
Related Party Role: Veterinary Premises
Name: VETERINARY EMERGENCY CLINIC, INC
License/Registration Type: Veterinary Premises
License Number: 4323 Primary Status: Cancelled
Address :
1800 Prescott Rd Ste E
MODESTO CA 95350-2560
STANISLAUS COUNTY
Premises to Managing Licensee
License/Registration Role: Veterinarian
Related Party Role: Veterinary Premises
Name: Standiford Veterinary Center INC
License/Registration Type: Veterinary Premises
License Number: 37714 Primary Status: Cancelled
Address :
1520 Standiford Ave
MODESTO CA 95350-0568
STANISLAUS COUNTY
Supervisor (Vet) to VACS Permit
License/Registration Role: Veterinarian
Related Party Role: Veterinary Assistant Controlled Substance Permit
Name: Tillery, Lisa Cantu
License/Registration Type: Veterinary Assistant Controlled Substance Permit
License Number: 4896 Primary Status: Current
Address :
2933 Beacon Hill Ln
MODESTO CA 95355-8944
STANISLAUS COUNTY
Supervisor (Vet) to VACS Permit
License/Registration Role: Veterinarian
Related Party Role: Veterinary Assistant Controlled Substance Permit
Name: Smith, Katelyn Ann
License/Registration Type: Veterinary Assistant Controlled Substance Permit
License Number: 7273 Primary Status: Expired
Address :
1801 Coffee Rd
11
MODESTO CA 95355-2720
STANISLAUS COUNTY
Supervisor (Vet) to VACS Permit
License/Registration Role: Veterinarian
Related Party Role: Veterinary Assistant Controlled Substance Permit
Name: Rodriguez, Tina
License/Registration Type: Veterinary Assistant Controlled Substance Permit
License Number: 6224 Primary Status: Current
Address :
3520 Roselle Ave
MODESTO CA 95357-1632
Supervisor (Vet) to VACS Permit
License/Registration Role: Veterinarian
Related Party Role: Veterinary Assistant Controlled Substance Permit
Name: Soltero Ruelas, Citlalli
License/Registration Type: Veterinary Assistant Controlled Substance Permit
License Number: 5100 Primary Status: Cancelled
Address :
1254 San Pedro Ave
CERES CA 95307-7453
STANISLAUS COUNTY
Supervisor (Vet) to VACS Permit
License/Registration Role: Veterinarian
Related Party Role: Veterinary Assistant Controlled Substance Permit
Name: PEREZ-MARTINEZ, ROSARIO
License/Registration Type: Veterinary Assistant Controlled Substance Permit
License Number: 4502 Primary Status: Current
Address :
1520 Standiford Ave
MODESTO CA 95350-0568
STANISLAUS COUNTY
Supervisor (Vet) to VACS Permit
License/Registration Role: Veterinarian
Related Party Role: Veterinary Assistant Controlled Substance Permit
Name: Williamson, Ashley Rose
License/Registration Type: Veterinary Assistant Controlled Substance Permit
License Number: 8895 Primary Status: Expired
Address :
1520 Standiford Ave
MODESTO CA 95350
STANISLAUS COUNTY
Supervisor (Vet) to VACS Permit
License/Registration Role: Veterinarian
Related Party Role: Veterinary Assistant Controlled Substance Permit
Name: JIMENEZ, YESENIA
License/Registration Type: Veterinary Assistant Controlled Substance Permit
License Number: 15305 Primary Status: Current
Address :
1520 Standiford Ave
MODESTO CA 95350-0568
STANISLAUS COUNTY
Supervisor (Vet) to VACS Permit
License/Registration Role: Veterinarian
Related Party Role: Veterinary Assistant Controlled Substance Permit
Name: Atkins, Jayden Rasheed
License/Registration Type: Veterinary Assistant Controlled Substance Permit
License Number: 16088 Primary Status: Current
Address :
1520 Standiford Ave
MODESTO CA 95350-0568
STANISLAUS COUNTY
Supervisor (Vet) to VACS Permit
License/Registration Role: Veterinarian
Related Party Role: Veterinary Assistant Controlled Substance Permit
Name: Betashoor, Sidory
License/Registration Type: Veterinary Assistant Controlled Substance Permit
License Number: 7919 Primary Status: Current
Address :
955 W Springer Dr
TURLOCK CA 95382-0273
STANISLAUS COUNTY
Supervisor (Vet) to VACS Permit
License/Registration Role: Veterinarian
Related Party Role: Veterinary Assistant Controlled Substance Permit
Name: RUCKER, LISA MARIE
License/Registration Type: Veterinary Assistant Controlled Substance Permit
License Number: 4558 Primary Status: Current
Address :
4512 Lucinda Ave
KEYES CA 95328-9785
STANISLAUS COUNTY
Supervisor (Vet) to VACS Permit
License/Registration Role: Veterinarian
Related Party Role: Veterinary Assistant Controlled Substance Permit
Name: Ortiz, Julian Abraham
License/Registration Type: Veterinary Assistant Controlled Substance Permit
License Number: 4731 Primary Status: Expired
Address :
10337 Alvarado Rd
OAKDALE CA 95361-8533
STANISLAUS COUNTY
