Dental Board of California
Licensing details for: 40432
Name: ETEMADI, KHASHAYAR
License Type: Dentist
Primary Status: Current - Active
Address of Record
12729 FOOTHILL BLVD
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: STAR DENTAL GROUP DR K ETEMADI
License/Registration Type: Fictitious Name Permit
License Number: 1232 Primary Status: Cancelled
Address :
12729 FOOTHILL BLVD SUITE A
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO 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: STAR DENTAL GROUP DR K ETEMADI
License/Registration Type: Fictitious Name Permit
License Number: 1232 Primary Status: Cancelled
Address :
12729 FOOTHILL BLVD SUITE A
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO COUNTY
