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Licensing details for: 809

Name: MANOUCHEHRI, ALI

License Type: Oral Conscious Sedation

Primary Status: Cancelled

Specialty: Minor

Address of Record

31 Cuervo Dr
ALISO VIEJO CA 92656-1741
ORANGE county
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Issuance Date

July 7, 2005

Expiration Date

April 30, 2024

Current Date / Time

June 6, 2025
2:24:21 AM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: TRI-CITY CHILDREN'S DENTISTRY, DENTAL OFFICE OF ALI MANOUCHEHRI,

License/Registration Type: Fictitious Name Permit

License Number: 7725 Primary Status: Cancelled

Address :
3230 WARING COURT #Q
OCEANSIDE CA 92056
SAN DIEGO COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: CHILDREN'S DENTAL FUN ZONE VII, DENTAL OFFICE OF MANOUCHEHRI AND

License/Registration Type: Fictitious Name Permit

License Number: 11905 Primary Status: Current - Active

Address :
701 N MILLIKEN AVENUE
#701B
ONTARIO CA 91764
SAN BERNARDINO 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: MANOUCHEHRI, ALI

License/Registration Type: Dentist License

License Number: 49934 Primary Status: Current - Active

Address :
31 Cuervo Dr
ALISO VIEJO CA 92656-1741
ORANGE COUNTY

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