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Licensing details for: 11540

Name: SCOTT JACKS, D.D.S., INC.

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: SCOTT JACKS,DDS, INC

Address of Record

4138 N. MAINE AVE STE M-2
BALDWIN PARK CA 91706
LOS ANGELES county
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Practice Location

4138 N. MAINE AVE STE M-2
BALDWIN PARK CA 91706
LOS ANGELES county
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Issuance Date

September 16, 2014

Expiration Date

August 31, 2015

Current Date / Time

June 22, 2025
6:16:1 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: JACKS, SCOTT THOMAS

License/Registration Type: Dentist License

License Number: 24464 Primary Status: Deceased

Address :
28 CENTERPOINTE DR
LA PALMA CA 90623
ORANGE COUNTY

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