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Licensing details for: 79242

Name: MICHELLE TO DDS AND ROGER LIM DDS, A PROFESSIONAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

368 N Lemon Ave # C
WALNUT CA 91789-2345
LOS ANGELES county
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Practice Location

368 N Lemon Ave # C
WALNUT CA 91789-2345
LOS ANGELES county
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Issuance Date

March 1, 2017

Expiration Date

December 31, 2018

Current Date / Time

June 7, 2025
4:51:5 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: LIM, ROGER SHERMAN

License/Registration Type: Dentist License

License Number: 45487 Primary Status: Current - Active

Address :
13308 Moorpark St
SHERMAN OAKS CA 91423-3918
LOS ANGELES 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: TO, MICHELLE P

License/Registration Type: Dentist License

License Number: 46337 Primary Status: Current - Active

Address :
12128 Vanowen St
NORTH HOLLYWOOD CA 91605-5651
LOS ANGELES COUNTY

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