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Licensing details for: 11642

Name: RAJESH M SHAH DDS

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Sole Owner

Previous Names: ALLURE DENTAL ASSOCIATES/ SHARMISTA A PATEL I GEN PTR

Address of Record

17024 VAN BUREN BLVD
#B
RIVERSIDE CA 92504
RIVERSIDE county
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Practice Location

17024 VAN BUREN BLVD
#B
RIVERSIDE CA 92504
RIVERSIDE county
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Issuance Date

December 22, 2014

Expiration Date

July 31, 2017

Current Date / Time

June 22, 2025
11:9:25 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: SHAH, RAJESH MADHUSUDAN

License/Registration Type: Dentist License

License Number: 46135 Primary Status: Current - Active

Address :
205 Saint Tropez Ct
PLACENTIA CA 92870-5133
ORANGE COUNTY

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