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Licensing details for: 11238

Name: ALLEN RONALD BAKER, DDS

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Sole Owner

Address of Record

12630 BROOKHURST STREET
GARDEN GROVE CA 92840
ORANGE county
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Practice Location

12630 BROOKHURST STREET
GARDEN GROVE CA 92840
ORANGE county
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Issuance Date

October 24, 2013

Expiration Date

December 31, 2016

Current Date / Time

June 7, 2025
3:45:29 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: BAKER, ALLEN RONALD

License/Registration Type: Dentist License

License Number: 20609 Primary Status: Current - Active

Address :
500 San Fernando Mission Blvd
Ste 200
SAN FERNANDO CA 91340-4061
LOS ANGELES COUNTY

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