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Licensing details for: 1190

Name: BATO, TRICIA DAVID

License Type: Conscious Sedation

Primary Status: Cancelled

Address of Record

1129 S Glendora Ave
WEST COVINA CA 91790-4955
LOS ANGELES county
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Practice Location

1920 E 17th St
101
SANTA ANA CA 92705-8626
ORANGE county
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770 Magnolia Ave
2E
CORONA CA 92879-3120
RIVERSIDE county
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Issuance Date

April 17, 2019

Expiration Date

May 31, 2023

Current Date / Time

June 7, 2025
2:26:58 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: BATO, TRICIA DAVID

License/Registration Type: Dentist License

License Number: 53695 Primary Status: Current - Active

Address :
770 Magnolia Ave
2E
CORONA CA 92879
RIVERSIDE COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: WESCOVE FAMILY DENTISTRY DENTAL OFFICE OF DR. KOUZ AND DR. BATO

License/Registration Type: Fictitious Name Permit

License Number: 18878 Primary Status: Current - Active

Address :
1129 S. GLENDORA BLVD
WEST COVINA CA 91790
LOS ANGELES COUNTY

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