License holder summary

POLK STACEY BERENICE is a Registered Dental Assistant licensed to practice in California. This dentist license is not current. The license was granted 05/16/1991 and expired on 06/30/2008.

Department of Consumer Affairs

Dental Board of California

POLK STACEY BERENICE
Registered Dental Assistant
License number
34651
Date granted
05/16/1991
Date expires
06/30/2008
Class
Registered Dental Assistant
Status
SUSP-NO QUALIFIER
dentistscalifornia.org
ID 10981112
LAST UPDATED 2021-09-13 14:22:11 UTC

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