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Licensing details for: 100739

Name: BACHOUR, MAXIME

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Previous Names: Bachour, Maxime

Address of Record

1941 Huntington Dr
Suite H
SOUTH PASADENA CA 91030
LOS ANGELES county
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Practice Location

1941 Huntington Dr
Suite H
SOUTH PASADENA CA 91030-4967
LOS ANGELES county
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Issuance Date

August 18, 2016

Expiration Date

June 30, 2026

Current Date / Time

December 13, 2025
9:42:45 AM

License Relationships

FNP to DDS or OMS

License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Related Party Role: Fictitious Name Permit

Name: SOUTH PASADENA ENDODONTICS DENTAL OFFICE OF BACHOUR-LU DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 18109 Primary Status: Current - Active

Address :
1941 HUNTINGTON DR UNIT H
SOUTH PASADENA CA 91030
LOS ANGELES COUNTY

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