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Licensing details for: 79689

Name: BOLURO-AJAYI AND TO DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

10286 INDIANA AVE
RIVERSIDE CA 92503
RIVERSIDE county
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Practice Location

10286 INDIANA AVE
RIVERSIDE CA 92503
RIVERSIDE county
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Issuance Date

May 30, 2018

Expiration Date

June 30, 2025

Current Date / Time

June 6, 2025
3:38:7 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: AJAYI, BUKI

License/Registration Type: Dentist License

License Number: 63727 Primary Status: Current - Active

Address :
10286 Indiana ave
RIVERSIDE CA 92503
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: 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: 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: WATANABE, BRYAN KAZUMI

License/Registration Type: Dentist License

License Number: 40130 Primary Status: Current - Active

Address :
40760 California Oaks Rd.
MURRIETA CA 92562
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: TO, JOAN THANH

License/Registration Type: Dentist License

License Number: 53880 Primary Status: Current - Active

Address :
5023 Pacific Coast Hwy
TORRANCE CA 90505-5441

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