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Licensing details for: 10443

Name: DENTAL CORP. OF CHARLES RODGERS AND CAROLYN GHAZAL

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: DENTAL CORPORATION OF CHARLES RODGERS AND CAROLYN GHAZAL

Address of Record

1259 PLEASANT GROVE BLVD
STE 100
ROSEVILLE CA 95678
PLACER county
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Practice Location

1259 PLEASANT GROVE BLVD STE 100
ROSEVILLE CA 95678
PLACER county
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Issuance Date

March 21, 2011

Expiration Date

June 30, 2016

Current Date / Time

June 7, 2025
3:25:7 AM

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: RODGERS, CHARLES FREDERICK

License/Registration Type: Dentist License

License Number: 35324 Primary Status: Current - Active

Address :
131 W Ontario Ave
Suite 103
CORONA CA 92882-5274
RIVERSIDE COUNTY

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