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Licensing details for: 13

Name: EUGENE A GONCHAROV, DDS

License Type: Mobile Dental Clinic

Primary Status: Cancelled

Address of Record

6221 WILSHIRE BLVD, STE 303
LOS ANGELES CA 90048
LOS ANGELES county
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Issuance Date

June 12, 2002

Expiration Date

January 31, 2007

Current Date / Time

June 7, 2025
7:20:54 PM

License Relationships

MDC to DDS or OMS

License/Registration Role: Mobile Dental Clinic Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: GONCHAROV, EVGENI ALEXANDER

License/Registration Type: Dentist License

License Number: 40823 Primary Status: Current - Active

Address :
15 Caladium
RANCHO SANTA MARGARI CA 92688-8739
ORANGE COUNTY

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