JOHN FRED ANDERSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****58

License Status

NOT RENEWED

Business

Title

DDS

First Name

JOHN

Middle

FRED

Last Name

ANDERSON

Business Name

JOHN FRED ANDERSON DDS

Original Issue Date

09/11/2017

Effective Date

11/19/2021

Expiration Date

09/30/2024

City

PACIFIC PALISADES

State

Zip

90272

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025