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Licensing details for: 711

Name: LOITZ, GREG ALLEN

License Type: Dentist General Anesthesia

Primary Status: Cancelled

Address of Record

33 PALMA AVENUE
LA SELVA BEACH CA 95076
SANTA CRUZ county
Map

Issuance Date

July 1, 1984

Expiration Date

May 31, 2017

Current Date / Time

June 7, 2025
6:48:54 AM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: THE SPECIALTY DENTAL CARE GROUP, PEDER H. HAMILTON, DDS

License/Registration Type: Fictitious Name Permit

License Number: 1352 Primary Status: Cancelled

Address :
15000 LOS GATOS BLVD
LOS GATOS CA 95032
SANTA CLARA COUNTY

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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: LOITZ, GREG ALLEN

License/Registration Type: Dentist License

License Number: 28354 Primary Status: Cancelled

Address :
33 PALMA AVENUE
LA SELVA BEACH CA 95076-1729
SANTA CRUZ COUNTY

Map

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