Dental Board of California
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
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SIMI VALLEY DENTAL GROUP AND ORTHODONTICS, GOGILTAN WAXLER AND SE
License/Registration Type: Fictitious Name Permit
License Number: 12075 Primary Status: Cancelled
Address :
2410 SYCAMORE DRIVE, SUITE A
SIMI VALLEY CA 93065
VENTURA COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SIMI VALLEY DENTAL GROUP, GOGILTAN WAXLER AND SETAREH DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17974 Primary Status: Current - Active
Address :
3013 COCHRAN STREET, SUITE D
SIMI VALLEY CA 93065
VENTURA 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: 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
