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Licensing details for: 79237

Name: DAVID CARLISLE DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

2878 Campus Pkwy
SUITE 1
RIVERSIDE CA 92507-0966
RIVERSIDE county
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Practice Location

2878 Campus Pkwy
SUITE 1
RIVERSIDE CA 92507-0966
RIVERSIDE county
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Issuance Date

March 1, 2017

Expiration Date

May 31, 2017

Current Date / Time

June 6, 2025
2:28:43 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: CARLISLE, DAVID JAMES

License/Registration Type: Dentist License

License Number: 43765 Primary Status: Current - Active

Address :
31737 Riverside Dr
Suite B
LAKE ELSINORE CA 92530-7890
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: 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: CHOKKA, SUDHAKAR RAO

License/Registration Type: Dentist License

License Number: 41376 Primary Status: Current - Active

Address :
27949 Greenspot Rd
Ste. H
HIGHLAND CA 92346-4443
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: ELIE, ARASH

License/Registration Type: Dentist License

License Number: 47470 Primary Status: Current - Active

Address :
15740 GREENLEAF STREET
ENCINO CA 91436
LOS ANGELES COUNTY

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