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Licensing details for: 11730

Name: SAHAWNEH DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

12052 Imperial Hwy
SUITE 101
NORWALK CA 90650-3090
LOS ANGELES county
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Practice Location

12052 E IMPERIAL HWY
SUITE 101
NORWALK CA 90650
LOS ANGELES county
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Issuance Date

March 13, 2015

Expiration Date

December 31, 2023

Current Date / Time

June 7, 2025
7:19:38 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: SAHAWNEH, SHOROUQ SAMEER

License/Registration Type: Dentist License

License Number: 55643 Primary Status: Current - Active

Address :
2300 Harbor Blvd.
Suite H5
COSTA MESA CA 92626
ORANGE COUNTY

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