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Licensing details for: 1706

Name: BOUTROS, SHADI FIKRY

License Type: Dentist General Anesthesia

Primary Status: Current - Active

Previous Names: BOUTROS, SHADI F

Address of Record

4906 Colchester Ct
DUBLIN CA 94568-4828
ALAMEDA county
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Practice Location

2500 Alhambra Ave
MARTINEZ CA 94553-3156
CONTRA COSTA county
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Issuance Date

July 11, 2014

Expiration Date

January 31, 2028

Current Date / Time

December 13, 2025
11:47:57 PM

License Relationships

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: BOUTROS, SHADI FIKRY

License/Registration Type: Dentist License

License Number: 54887 Primary Status: Current - Active

Address :
2500 Alhambra Ave
MARTINEZ CA 94553-3156
CONTRA COSTA COUNTY

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