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Licensing details for: 79309

Name: GHAZAL AND RODGERS DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

5731 E SANTA ANA CANYON STE A
ANAHEIM CA 92807
ORANGE county
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Practice Location

5925 BIRDCAGE CENTRE LN STE D105
CITRUS HEIGHTS CA 95610
SACRAMENTO county
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Issuance Date

May 1, 2017

Expiration Date

August 31, 2017

Current Date / Time

June 6, 2025
8:55:19 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: RODGERS, CHARLES FREDERICK

License/Registration Type: Dentist License

License Number: 35324 Primary Status: Current - Active

Address :
131 W Ontario Ave
Suite 103
CORONA CA 92882-5274
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: 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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