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Licensing details for: 80031

Name: POURSHIRAZI & SAREH DENTAL CORP.

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

2015 N. WATERMAN AVE STE B
SAN BERNARDINO CA 92404
SAN BERNARDINO county
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Practice Location

2015 N. WATERMAN AVE STE B
SAN BERNARDINO CA 92404
SAN BERNARDINO county
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Issuance Date

April 4, 2019

Expiration Date

January 31, 2022

Current Date / Time

April 2, 2026
11:32:11 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: POURSHIRAZI, HOMAYOUN

License/Registration Type: Dentist License

License Number: 44064 Primary Status: Current - Active

Address :
27192 Newport Rd
SUITE 2
MENIFEE CA 92584-7387
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: SAREH, ATEFEH

License/Registration Type: Dentist License

License Number: 41993 Primary Status: Current - Active

Address :
12121 Wilshire Blvd
Suite 1111
LOS ANGELES CA 90025-1123
LOS ANGELES COUNTY

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