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Licensing details for: 1330

Name: RESHAD, MOHAMMAD

License Type: Conscious Sedation

Primary Status: Cancelled

Address of Record

1617 S Beverly Glen Blvd
Apt 208
LOS ANGELES CA 90024-1712
LOS ANGELES county
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Issuance Date

December 16, 2021

Expiration Date

March 31, 2024

Current Date / Time

June 6, 2025
9:33:38 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: RESHAD, MOHAMMAD

License/Registration Type: Dentist License

License Number: 105699 Primary Status: Current - Active

Address :
1617 S Beverly Glen Blvd
208
LOS ANGELES CA 90024-1712
LOS ANGELES COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: RESHAD DENTAL CORP

License/Registration Type: Fictitious Name Permit

License Number: 19306 Primary Status: Current - Active

Address :
27871 MEDICAL CENTER RD. SUITE: 260
MISSION VIEJO CA 92691
ORANGE COUNTY

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