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Licensing details for: 79461

Name: PEGGY CHU DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

2841 S DIAMOND BAR BLVD STE B
DIAMOND BAR CA 91765
LOS ANGELES county
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Practice Location

2841 S DIAMOND BAR BLVD STE B
DIAMOND BAR CA 91765
LOS ANGELES county
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Issuance Date

September 25, 2017

Expiration Date

December 31, 2024

Current Date / Time

June 6, 2025
2:30:54 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: SAMBANGI, MANORANJANI

License/Registration Type: Dentist License

License Number: 50520 Primary Status: Current - Active

Address :
CHINO HILLS DENTAL GROUP
3410 GRAND AVE
CHINO HILLS CA 91709
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: MOORE, ANDREA CHRISTIANE

License/Registration Type: Dentist License

License Number: 48337 Primary Status: Current - Active

Address :
1875 N Campus Ave
UPLAND CA 91784-8208
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: 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: CHU, PEGGY PEI-YING

License/Registration Type: Dentist License

License Number: 52974 Primary Status: Current - Active

Address :
2841 S. DIAMOND BAR BLVD
SUITE B
DIAMOND BAR CA 91765
LOS ANGELES COUNTY

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