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Licensing details for: 61522

Name: ANTIPOVA, OLGA

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

490 POST ST #1022
SAN FRANCISCO CA 94102
SAN FRANCISCO county
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Issuance Date

July 17, 2012

Expiration Date

June 30, 2025

Current Date / Time

June 7, 2025
11:3:47 AM

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: ANTIPOV DENTAL INC.

License/Registration Type: Additional Office Permit

License Number: 80938 Primary Status: Expired

Address :
490 POST STEET, STE. 1022
SAN FRANCISCO CA 94102
SAN FRANCISCO COUNTY

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OCS to DDS, OMS, or SP

License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Related Party Role: Oral Conscious Sedation Certificate

Name: ANTIPOVA, OLGA

License/Registration Type: Oral Conscious Sedation Certificate

License Number: 3164 Primary Status: Cancelled

Address :
4145 SHADOW LANE #524
SANTA ROSA CA 95405
SONOMA COUNTY

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