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Licensing details for: 80583

Name: MICHELLE P H TO DDS A PROFESSIONAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

13320 RIVERSIDE DRIVE #202
SHERMAN OAKS CA 91423
LOS ANGELES county
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Practice Location

13320 RIVERSIDE DRIVE #202
SHERMAN OAKS CA 91423
LOS ANGELES county
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Issuance Date

June 9, 2020

Expiration Date

December 31, 2022

Current Date / Time

June 7, 2025
4:35:51 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: TO, MICHELLE P

License/Registration Type: Dentist License

License Number: 46337 Primary Status: Current - Active

Address :
12128 Vanowen St
NORTH HOLLYWOOD CA 91605-5651
LOS ANGELES COUNTY

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