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Licensing details for: 80366

Name: AHMAD KHAN DENTAL CORP

License Type: Additional Office Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

1530 W. 6TH ST., 101-A
CORONA CA 92882
RIVERSIDE county
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Practice Location

1530 W. 6TH ST., 101-A
CORONA CA 92882
RIVERSIDE county
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Issuance Date

November 13, 2019

Expiration Date

July 31, 2020

Current Date / Time

June 7, 2025
4:56:2 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: AHMAD, MUHAMMAD FAROOQ

License/Registration Type: Dentist License

License Number: 45080 Primary Status: Current - Active

Address :
1245 E VISTA WAY
VISTA CA 92084
SAN DIEGO 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: KHAN, SHEHZAD AHMAD

License/Registration Type: Dentist License

License Number: 54611 Primary Status: Current - Active

Address :
18 Rancho Camino Dr
STE. 104
POMONA CA 91766-7003
LOS ANGELES COUNTY

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