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Licensing details for: 1228

Name: CALDEMEYER, CORTLAND S

License Type: Dentist General Anesthesia

Primary Status: Cancelled

Previous Names: CALDEMEYER, CORTLAND CALDEMEYER, CORTLAND STEVEN

Address of Record

1706 MEDICAL PARK DR
WILSON NC 27893
WILSON county
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Issuance Date

August 23, 2001

Expiration Date

June 30, 2017

Current Date / Time

June 7, 2025
9:14:54 PM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: CENTER FOR ORAL & FACIAL SURGERY, DENTAL GROUP OF

License/Registration Type: Fictitious Name Permit

License Number: 4801 Primary Status: Cancelled

Address :
306 WALNUT AVE, STE 26
SAN DIEGO CA 92103
SAN DIEGO COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: CENTER FOR ORAL & FACIAL SURGERY, DENTAL GROUP

License/Registration Type: Fictitious Name Permit

License Number: 3495 Primary Status: Cancelled

Address :
150 WEST MADISON AVE
EL CAJON CA 92020
SAN DIEGO COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: CENTER FOR ORAL & FACIAL SURGERY, DENTAL GROUP

License/Registration Type: Fictitious Name Permit

License Number: 3494 Primary Status: Cancelled

Address :
306 WALNUT AVENUE, STE 26
SAN DIEGO CA 92103
SAN DIEGO COUNTY

Map

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: CENTER FOR ORAL & FACIAL SURGERY, DENTAL GROUP OF

License/Registration Type: Fictitious Name Permit

License Number: 4786 Primary Status: Cancelled

Address :
150 W MADISON
EL CAJON CA 92020
SAN DIEGO COUNTY

Map

GA to DDS or OMS or SP

License/Registration Role: General Anesthesia Permit

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: CALDEMEYER, CORTLAND S

License/Registration Type: Dentist License

License Number: 47693 Primary Status: Cancelled

Address :
920 S WILLOW AVE
COOKEVILLE TN 38501
PUTNAM COUNTY

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