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Licensing details for: 837

Name: GOGILTAN-WAXLER, ELENA LUCIA

License Type: Oral Conscious Sedation

Primary Status: Cancelled

Specialty: Minor

Address of Record

7140 SALISBURY
WEST HILLS CA 91307
LOS ANGELES county
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Issuance Date

August 31, 2005

Expiration Date

November 30, 2018

Current Date / Time

November 3, 2025
3:5:0 AM

License Relationships

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: GOGILTAN-WAXLER, ELENA LUCIA

License/Registration Type: Dentist License

License Number: 47080 Primary Status: Current - Active

Address :
3013 COCHRAN ST
# D
SIMI VALLEY CA 93065
VENTURA COUNTY

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