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Licensing details for: 79045

Name: AMANDA MERCER AND DIANA DO-YABUT DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

300 Carlsbad Village Dr
SUITE 203
CARLSBAD CA 92008-2900
SAN DIEGO county
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Practice Location

300 Carlsbad Village Dr
SUITE 203
CARLSBAD CA 92008-2900
SAN DIEGO county
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Issuance Date

June 30, 2016

Expiration Date

December 31, 2019

Current Date / Time

June 6, 2025
3:40:9 PM

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: REAGAN, DARIN SCOTT

License/Registration Type: Dentist License

License Number: 34407 Primary Status: Current - Active

Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
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: MERCER, AMANDA ASHLEY

License/Registration Type: Dentist License

License Number: 63478 Primary Status: Current - Active

Address :
3150 Case Rd
Bldg C
PERRIS CA 92570-5551
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: NOSTI, JOHN CHARLES

License/Registration Type: Dentist License

License Number: 48655 Primary Status: Current - Active

Address :
709 Center Dr Ste 101
SAN MARCOS CA 92069-2502
SAN DIEGO 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: RYGG, LANCE CHRISTIAN

License/Registration Type: Dentist License

License Number: 30251 Primary Status: Cancelled

Address :
9862 E MISSION GORGE RD, STE E
SANTEE CA 92071
SAN DIEGO 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: DO YABUT, DIANA SONG

License/Registration Type: Dentist License

License Number: 53903 Primary Status: Current - Active

Address :
20201 CHIANTI COURT
YORBA LINDA CA 92886
ORANGE COUNTY

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