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Licensing details for: 10358

Name: HAYASHI DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: RANDALL T HAYASHI DDS INC

Address of Record

531 KETTLEMAN LANE
LODI CA 95240
SAN JOAQUIN county
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Practice Location

531 KETTLEMAN LANE
LODI CA 95240
SAN JOAQUIN county
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Issuance Date

January 20, 2011

Expiration Date

November 30, 2015

Current Date / Time

June 6, 2025
3:27:49 PM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: HAYASHI, RANDALL TOYSON

License/Registration Type: Dentist License

License Number: 36765 Primary Status: Current - Active

Address :
8102 Pollard Ave
FAIR OAKS CA 95628-6059
SACRAMENTO COUNTY

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