Dental Board of California
Licensing details for: 35914
Name: ISKAQ, DYANADEWI JUSWANTO
License Type: Dentist
Primary Status: Current - Active
Previous Names: JUSWANTO, DYANADEWI
Address of Record
824 E Miramar Ave
CLAREMONT CA 91711-2020
LOS ANGELES county
Map
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: ISKAQ AND GILL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79469 Primary Status: Cancelled
Address :
2216 FOOTHILL BLVD
LA VERNE CA 91750
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: LA VERNE DENTAL GROUP, ISKAQ AND GILL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13783 Primary Status: Cancelled
Address :
2216 FOOTHILL BLVD
LA VERNE CA 91750
LOS ANGELES COUNTY
