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Licensing details for: 1099

Name: ZARRABI, SHAHROUZ

License Type: Conscious Sedation

Primary Status: Cancelled

Secondary Status: Cancelled at the Request of the LicenseePrimary Status Definition

Previous Names: Zarrabi, Shahrouz

Address of Record

278 Ambroise
NEWPORT BEACH CA 92657
ORANGE county
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Practice Location

12761 MORENO BEACH DR STE 103
MORENO VALLEY CA 92555
RIVERSIDE county
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Issuance Date

June 9, 2017

Expiration Date

March 21, 2018

Current Date / Time

June 6, 2025
1:53:31 AM

License Relationships

CS to DDS, OMS, or SP

License/Registration Role: Conscious Sedation Permit

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

Name: ZARRABI, SHAHROUZ

License/Registration Type: Dentist License

License Number: 101197 Primary Status: Current - Active

Address :
2865 E. Coast Hwy, Suite 300
CORONA DEL MAR CA 92625
ORANGE COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: ZARRABI MD, FACIAL COSMETIC AND MAXILLO-FACIAL SURGERY, DENTAL PRACTICE

License/Registration Type: Fictitious Name Permit

License Number: 14611 Primary Status: Current - Active

Address :
2865 EAST COAST HWY STE 300
CORONA DEL MAR CA 92625
ORANGE COUNTY

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