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Licensing details for: 82017

Name: DIANE BOVAL, DDS

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

613 N. AZUSA AVE., SUITE B
AZUSA CA 91702
LOS ANGELES county
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Practice Location

613 N. AZUSA AVE., SUITE B
AZUSA CA 91702
LOS ANGELES county
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Issuance Date

January 14, 2025

Expiration Date

January 31, 2026

Current Date / Time

June 6, 2025
10:16:32 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: BOVAL, DIANE LEE

License/Registration Type: Dentist License

License Number: 48630 Primary Status: Current - Active

Address :
901 W Whittier Blvd
LA HABRA CA 90631-3743
ORANGE COUNTY

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