Dental Board of California
Licensing details for: 1991
Name: MCDONOUGH, SHAELAN DAVID
License Type: Oral Conscious Sedation
Primary Status: Cancelled
Specialty: Adult
Address of Record
593 N MOORPARK RD
STE B
THOUSAND OAKS CA 91360
VENTURA county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: EAST OAKS DENTAL GROUP, MCDONOUGH AND HUSS DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 10750 Primary Status: Cancelled
Address :
593 N. MOORPARK ROAD SUITE B
THOUSAND OAKS CA 91360
VENTURA COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: BRENTWOOD MODERN DENTISTRY DENTAL GROUP, MCDONOUGH DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16582 Primary Status: Current - Active
Address :
12013 WILSHIRE BLVD
LOS ANGELES CA 90025
LOS ANGELES COUNTY
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: MCDONOUGH, SHAELAN DAVID
License/Registration Type: Dentist License
License Number: 56210 Primary Status: Current - Active
Address :
12013 Wilshire Blvd
LOS ANGELES CA 90025-1201
LOS ANGELES COUNTY
