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Licensing details for: 9653

Name: FARIBORZ RODEF, DDS

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Sole Owner

Previous Names: FARIBORZ RODEF

Address of Record

569 WEST LOWELL AVE.
TRACY CA 95376
SAN JOAQUIN county
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Issuance Date

July 11, 2008

Expiration Date

January 31, 2015

Current Date / Time

June 7, 2025
5:6:33 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: RODEF, FARIBORZ

License/Registration Type: Dentist License

License Number: 38356 Primary Status: Current - Active

Address :
2233 E GARVEY AVE N
WEST COVINA CA 91791
LOS ANGELES COUNTY

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