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Licensing details for: 3474

Name: BOZORGMANESH, HAMED

License Type: Oral Conscious Sedation

Primary Status: Cancelled

Specialty: Minor

Address of Record

99 TALISMAN #936
IRVINE CA 92620
ORANGE county
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Issuance Date

April 28, 2016

Expiration Date

July 31, 2021

Current Date / Time

June 7, 2025
2:3:52 PM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: CHILDREN'S DENTAL FUN ZONE DENTAL OFFICE OF ROBLES, BOZORGMANESH, RODEF & YAGHOUBI DENTAL CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 14480 Primary Status: Cancelled

Address :
5628 VAN BUREN BLVD SUITE #A
RIVERSIDE CA 92503
RIVERSIDE 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: BOZORGMANESH, HAMED

License/Registration Type: Dentist License

License Number: 64776 Primary Status: Current - Active

Address :
38 Promontory Park
ALISO VIEJO CA 92656-3380
ORANGE COUNTY

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