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Licensing details for: 80938

Name: ANTIPOV DENTAL INC.

License Type: Additional Office Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

490 POST STEET, STE. 1022
SAN FRANCISCO CA 94102
SAN FRANCISCO county
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Practice Location

490 POST STEET, STE. 1022
SAN FRANCISCO CA 94102
SAN FRANCISCO county
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Issuance Date

May 19, 2021

Expiration Date

March 31, 2022

Current Date / Time

June 6, 2025
8:46:31 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: ANTIPOV, ALEXANDER V

License/Registration Type: Dentist License

License Number: 50724 Primary Status: Current - Active

Address :
911 Reserve Dr Ste 150
ROSEVILLE CA 95678
PLACER 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: ANTIPOVA, OLGA

License/Registration Type: Dentist License

License Number: 61522 Primary Status: Current - Active

Address :
490 POST ST #1022
SAN FRANCISCO CA 94102
SAN FRANCISCO COUNTY

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