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Licensing details for: 80391

Name: ELDER DENTAL CORP

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

19 ROTARY WAY
VALLEJO CA 94591
SOLANO county
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Practice Location

19 ROTARY WAY
VALLEJO CA 94591
SOLANO county
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Issuance Date

November 26, 2019

Expiration Date

January 31, 2023

Current Date / Time

June 6, 2025
2:29:5 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: ELDER, MAHR F

License/Registration Type: Dentist License

License Number: 46586 Primary Status: Current - Active

Address :
1805 Novato Blvd
Suite 1
NOVATO CA 94947-2934
MARIN COUNTY

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