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Licensing details for: 80137

Name: DE LA OSA DENTAL GROUP, INC.

License Type: Additional Office Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

4322 MAINE AVE
BALDWIN PARK CA 91706
LOS ANGELES county
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Practice Location

4322 MAINE AVE
BALDWIN PARK CA 91706
LOS ANGELES county
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Issuance Date

July 5, 2019

Expiration Date

March 31, 2026

Current Date / Time

June 5, 2026
8:05:20 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: DE LA OSA, JORGE C

License/Registration Type: Dentist License

License Number: 54134 Primary Status: Current - Active

Address :
20199 Valley Blvd
F
WALNUT CA 91789-2671
LOS ANGELES COUNTY

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