California Veterinary Medical Board
Licensing details for: 7031
Name: ROACH, R T
License Type: Veterinarian
Primary Status: Current
Previous Names: ROACH, R T DVM
Address of Record
SHASTA LAKE VETERINARY CLINIC
4522 Shasta Dam Blvd
SHASTA LAKE CA 96019-9412
SHASTA county
Map
License Relationships
Premises to Managing Licensee
License/Registration Role: Veterinarian
Related Party Role: Veterinary Premises
Name: SHASTA LAKE VETERINARY CLINIC
License/Registration Type: Veterinary Premises
License Number: 2879 Primary Status: Current
Address :
4522 Shasta Dam Blvd
SHASTA LAKE CA 96019-9412
SHASTA COUNTY
Supervisor (Vet) to VACS Permit
License/Registration Role: Veterinarian
Related Party Role: Veterinary Assistant Controlled Substance Permit
Name: MCINTOSH, GREG
License/Registration Type: Veterinary Assistant Controlled Substance Permit
License Number: 3555 Primary Status: Expired
Address :
4477 Main St
SHASTA LAKE CA 96019-9628
SHASTA COUNTY
Supervisor (Vet) to VACS Permit
License/Registration Role: Veterinarian
Related Party Role: Veterinary Assistant Controlled Substance Permit
Name: REEVES, JESSE RAY
License/Registration Type: Veterinary Assistant Controlled Substance Permit
License Number: 3760 Primary Status: Cancelled
Address :
CITY OF SHASTA LAKE ANIMAL CONTROL
4477 Main St
SHASTA LAKE CA 96019-9628
SHASTA COUNTY
Supervisor (Vet) to VACS Permit
License/Registration Role: Veterinarian
Related Party Role: Veterinary Assistant Controlled Substance Permit
Name: CORBELL, KRISTOPHER A
License/Registration Type: Veterinary Assistant Controlled Substance Permit
License Number: 3889 Primary Status: Cancelled
Address :
PO Box 777
SHASTA LAKE CA 96019-0777
SHASTA COUNTY
