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Licensing details for: 11527

Name: ENTABI DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

2600 S Tracy Blvd Ste 160
TRACY CA 95376-9111
SAN JOAQUIN county
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Practice Location

2600 S. TRACY BLVD, SUITE 160
TRACY CA 95376
SAN JOAQUIN county
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Issuance Date

August 27, 2014

Expiration Date

June 30, 2024

Current Date / Time

December 13, 2025
7:58:3 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: STROMBERG, LOUIS ZANE

License/Registration Type: Dentist License

License Number: 30879 Primary Status: Expired

Address :
16868 MAIN STREET
HESPERIA CA 92345
SAN BERNARDINO COUNTY

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