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Licensing details for: 79552

Name: SOROUR D.M.D CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

4138 MAINE AVE UNIT M2
BALDWIN PARK CA 91706
LOS ANGELES county
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Practice Location

4138 MAINE AVE UNIT M2
BALDWIN PARK CA 91706
LOS ANGELES county
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Issuance Date

December 21, 2017

Expiration Date

June 30, 2026

Current Date / Time

June 6, 2025
2:28:22 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: 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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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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