Pennsylvania
Department of State
JACQUES L LAKE
Dentistry - Anesthesia Permit - Restricted II
License number
DN016917A
Date granted
05/19/1989
Date expires
03/31/1997
Class
Dentistry - Anesthesia Permit - Restricted II
Status
Inactive
Address
FALLBROOK CA 92028
palicensing.org
ID 16538965
LAST UPDATED 2024-05-29 12:27:32 UTC
LAST UPDATED 2024-05-29 12:27:32 UTC
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