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Licensing details for: 78934

Name: CHU AND WATANABE DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

31843 Rancho California Rd
SUITE 300
TEMECULA CA 92591-5120
RIVERSIDE county
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Practice Location

31843 Rancho California Rd
SUITE 300
TEMECULA CA 92591-5120
RIVERSIDE county
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Issuance Date

April 4, 2016

Expiration Date

April 30, 2019

Current Date / Time

June 6, 2025
2:30:47 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: CHU, FRANKLIN TEH-SUN

License/Registration Type: Dentist License

License Number: 61692 Primary Status: Current - Active

Address :
31843 Rancho California Rd
STE 300
TEMECULA CA 92591-5120
RIVERSIDE 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: SHARIFIAN, ALEX R.

License/Registration Type: Dentist License

License Number: 44540 Primary Status: Current - Active

Address :
13721 Newport Ave
Suite 1
TUSTIN CA 92780-4690
ORANGE 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: WATANABE, LYNDA CAROL

License/Registration Type: Dentist License

License Number: 40116 Primary Status: Current - Active

Address :
8715 Trautwein Rd
RIVERSIDE CA 92508-9474
RIVERSIDE COUNTY

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