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Licensing details for: 81350

Name: ELGENDI DDS CORPORATION

License Type: Additional Office Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

1161 HIDDEN VALLEY PKWY #106
NORCO CA 92860
RIVERSIDE county
Map

Practice Location

1161 HIDDEN VALLEY PKWY #106
NORCO CA 92860
RIVERSIDE county
Map

Issuance Date

November 2, 2022

Expiration Date

March 31, 2024

Current Date / Time

December 13, 2025
9:49:16 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: ELGENDI, HAITHAM HAMZA

License/Registration Type: Dentist License

License Number: 46787 Primary Status: Current - Active

Address Not Disclosed

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