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Licensing details for: 8558

Name: JACKSON AND MOORE DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

1047 HARRIMAN PLACE, STE B
SAN BERNARDINO CA 92408
SAN BERNARDINO county
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Issuance Date

June 13, 2005

Expiration Date

October 31, 2016

Current Date / Time

June 7, 2025
3:34:17 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: MOORE, ANDREA CHRISTIANE

License/Registration Type: Dentist License

License Number: 48337 Primary Status: Current - Active

Address :
1875 N Campus Ave
UPLAND CA 91784-8208
SAN BERNARDINO 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: JACKSON, TANISHA ANJANETTE

License/Registration Type: Dentist License

License Number: 47103 Primary Status: Current - Active

Address :
422 Orange St
REDLANDS CA 92374-3206
SAN BERNARDINO COUNTY

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