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Licensing details for: 104061

Name: JANNOTTA, GABRIELLE ROSE

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

6745 Westminster Blvd Ste B
WESTMINSTER CA 92683-8069
ORANGE county
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Issuance Date

July 16, 2019

Expiration Date

April 30, 2028

Current Date / Time

October 27, 2026
8:59:20 PM

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: Westminster Modern Dentistry, Dental Group of Westminster Modern Dentistry, Inc.

License/Registration Type: Fictitious Name Permit

License Number: 21044 Primary Status: Current - Active

Address :
6745 Westminster Blvd Ste B
WESTMINSTER CA 92683-8069
ORANGE COUNTY

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