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Licensing details for: 78

Name: NORWALK VILLAGE DENTAL CENTER

License Type: Mobile Dental Clinic

Primary Status: Expired Primary Status Definition

Address of Record

11274 FIRESTONE BLVD
NORWALK CA 90650
LOS ANGELES county
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Issuance Date

November 24, 2014

Expiration Date

June 30, 2022

Current Date / Time

June 6, 2025
1:59:47 AM

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: NOOR, ASMATH SUHALE

License/Registration Type: Dentist License

License Number: 43307 Primary Status: Current - Active

Address :
11274 E FIRESTONE BLVD
NORWALK CA 90650
LOS ANGELES COUNTY

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