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Licensing details for: 1276

Name: TELLISSI, OUALID

License Type: Conscious Sedation

Primary Status: Cancelled

Address of Record

72695 Highway 111 Suite A8
PALM DESERT CA 92260
RIVERSIDE county
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Issuance Date

May 13, 2021

Expiration Date

November 30, 2024

Current Date / Time

June 6, 2025
1:52:10 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: TELLISSI, OUALID

License/Registration Type: Dentist License

License Number: 62427 Primary Status: Current - Active

Address :
72695 HIGHWAY 11 STE A-8
PALM DESERT CA 92260
RIVERSIDE COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: TELLISSI FAMILY DENTISTRY, DENTAL OFFICE OF O. TELLISSI DMD INC.

License/Registration Type: Fictitious Name Permit

License Number: 12015 Primary Status: Current - Active

Address :
72695 HIGHWAY 111, SUITE A-8
PALM DESERT CA 92260
RIVERSIDE COUNTY

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