Dental Board of California
Licensing details for: 105748
Name: DOUGLAS, JORDAN CHELSEY
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by ADEX
License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: DOUGLAS DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81416 Primary Status: Cancelled
Address :
10930 W. MAGNOLIA BLVD
NORTH HOLLYWOOD CA 91601
LOS ANGELES COUNTY
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: NOHO MODERN DENTISTRY DENTAL GROUP, DOUGLAS DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17633 Primary Status: Current - Active
Address :
10930 W. MAGNOLIA BLVD
NORTH HOLLYWOOD CA 91601
LOS ANGELES COUNTY
