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Licensing details for: 106189

Name: MAYBERRY, AARON LOUIS

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by ADEX

Address of Record

15631 Foster Rd
LA MIRADA CA 90638-3117
LOS ANGELES county
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Issuance Date

June 2, 2021

Expiration Date

March 31, 2026

Current Date / Time

June 6, 2025
3:9:5 PM

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: MAYBERRY DENTAL CORPORATION

License/Registration Type: Additional Office Permit

License Number: 81532 Primary Status: Current - Active

Address :
1047 E. HARRIMAN PLACE, SUITE B
SAN BERNARDINO CA 92408
SAN BERNARDINO COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: HUB PLAZA DENTAL GROUP, MAYBERRY DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 17896 Primary Status: Current - Active

Address :
1047 E. HARRIMAN PLACE, SUITE B
SAN BERNARDINO CA 92408
SAN BERNARDINO COUNTY

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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: HUB PLAZA DENTAL GROUP, MAYBERRY DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 17896 Primary Status: Current - Active

Address :
1047 E. HARRIMAN PLACE, SUITE B
SAN BERNARDINO CA 92408
SAN BERNARDINO COUNTY

Map

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