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Licensing details for: 1145

Name: MACIAS, AMBER MOORE

License Type: Oral Conscious Sedation

Primary Status: Cancelled

Specialty: Adult

Previous Names: MOORE, AMBER CATHERINE

Address of Record

1148 Macias Ct
SAN JOSE CA 95120-4247
SANTA CLARA county
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Issuance Date

March 12, 2007

Expiration Date

September 30, 2018

Current Date / Time

June 7, 2025
11:35:32 AM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: SANTEE COTTONWOOD DENTAL GROUP

License/Registration Type: Fictitious Name Permit

License Number: 3525 Primary Status: Cancelled

Address :
9715 MISSION GORGE RD
SANTEE CA 92071
SAN DIEGO COUNTY

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OCS to DDS, OMS, or SP

License/Registration Role: Oral Conscious Sedation Certificate

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

Name: MACIAS, AMBER MOORE

License/Registration Type: Dentist License

License Number: 46501 Primary Status: Current - Active

Address :
1148 Macias Ct
SAN JOSE CA 95120-4247
SANTA CLARA COUNTY

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