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Licensing details for: 446

Name: KHAN, GHAZALA R

License Type: Conscious Sedation

Primary Status: Cancelled

Previous Names: KHAN, GHAZALA RAHMAN

Address of Record

411 FUCHSIA LANE
SAN RAMON CA 94582
CONTRA COSTA county
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Issuance Date

July 20, 2004

Expiration Date

July 31, 2009

Current Date / Time

June 6, 2025
1:51:50 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: KHAN, GHAZALA R

License/Registration Type: Dentist License

License Number: 51483 Primary Status: Current - Active

Address :
327 Moffett Blvd Ste A
MOUNTAIN VIEW CA 94043-4757
SANTA CLARA COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: MANTECA ENDODONTICS, DENTAL PRACTICE OF GHAZALA R KHAN DDS DENTAL

License/Registration Type: Fictitious Name Permit

License Number: 10977 Primary Status: Cancelled

Address :
295 SUN HAVEN PLACE SUITE 1
MANTECA CA 95337
SAN JOAQUIN COUNTY

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