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Licensing details for: 11508

Name: MARK J. BROWN, D.D.S., INC.

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Secondary Status: Cancelled at the Request of the LicenseePrimary Status Definition

Address of Record

2503 BELL ROAD
AUBURN CA 95603
PLACER county
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Issuance Date

August 12, 2014

Expiration Date

August 31, 2017

Current Date / Time

June 7, 2025
3:42:34 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: GHAZAL, CAROLYN G

License/Registration Type: Dentist License

License Number: 38682 Primary Status: Current - Active

Address :
10797 FOOTHILL BLVD
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY

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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: BROWN, MARK JONATHAN

License/Registration Type: Dentist License

License Number: 58387 Primary Status: Current - Active

Address :
707 Zion St Ste C
NEVADA CITY CA 95959-2932
NEVADA COUNTY

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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: GILL, AMARDEEP KAUR

License/Registration Type: Dentist License

License Number: 50464 Primary Status: Current - Active

Address :
1450 E Main St
Ste 100
WOODLAND CA 95776-6201
YOLO COUNTY

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