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Licensing details for: 80930

Name: MICHELLE P TO DDS, A PROFESSIONAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

32144 AGOURA ROAD #216
WESTLAKE VILLAGE CA 91361
VENTURA county
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Practice Location

32144 AGOURA ROAD #216
WESTLAKE VILLAGE CA 91361
VENTURA county
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Issuance Date

May 14, 2021

Expiration Date

December 31, 2024

Current Date / Time

June 7, 2025
4:14:11 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: 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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