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Licensing details for: 79522

Name: SOROUR DENTAL GROUP CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

3173 TWEEDY BLVD
SOUTH GATE CA 90280
LOS ANGELES county
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Practice Location

3173 TWEEDY BLVD
SOUTH GATE CA 90280
LOS ANGELES county
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Issuance Date

November 6, 2017

Expiration Date

June 30, 2026

Current Date / Time

June 6, 2025
11:36:10 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: SOROUR, SELVANA

License/Registration Type: Dentist License

License Number: 54394 Primary Status: Current - Active

Address :
13340 HAWTHORNE BLVD
HAWTHORNE CA 90250
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: SOROUR, THARWAT

License/Registration Type: Dentist License

License Number: 54393 Primary Status: Current - Active

Address :
13340 HAWTHORNE BLVD
HAWTHORNE CA 90250
LOS ANGELES COUNTY

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