JEFERSON ALMEIDA VAN DEN BERGE Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****58

License Status

ACTIVE

Business

First Name

JEFERSON

Middle

ALMEIDA

Last Name

VAN DEN BERGE

Business Name

JEFERSON ALMEIDA VAN DEN BERGE

Original Issue Date

03/11/2022

Effective Date

06/03/2024

Expiration Date

09/30/2027

City

COSTA MESA

State

Zip

92626

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/03/2024