Dental Board of California
Licensing details for: 38372
Name: THEODORE, IRENE T
License Type: Dentist
Primary Status: Cancelled
Address of Record
4200 WEST PETERSON
NO 136
CHICAGO IL 60646
COOK county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CENTER FOR ORAL AND FACIAL SURGERY, DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 2139 Primary Status: Cancelled
Address :
FRANK PAVEL
150 WEST MADISON
EL CAJON CA 92020
SAN DIEGO 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: CENTER FOR ORAL AND FACIAL SURGERY, DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 2139 Primary Status: Cancelled
Address :
FRANK PAVEL
150 WEST MADISON
EL CAJON CA 92020
SAN DIEGO COUNTY
