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Licensing details for: 79245

Name: SHAH BHAGAT & UPPAL A PROFESSIONAL DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

770 Magnolia Ave Ste 1J
CORONA CA 92879-3100
RIVERSIDE county
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Practice Location

770 Magnolia Ave
Suite 1-J
770 Magnolia Ave, Suite 1-J
CORONA CA 92879-3120
RIVERSIDE county
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Issuance Date

March 7, 2017

Expiration Date

December 5, 2018

Current Date / Time

April 5, 2026
3:03:21 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: BHAGAT, RAJIV

License/Registration Type: Dentist License

License Number: 35471 Primary Status: Current - Active

Address :
770 Magnolia Ave
Suite 1-J
CORONA CA 92879-3120
RIVERSIDE COUNTY

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