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Licensing details for: 10511

Name: UPLAND DENTAL AESTHETICS & ORTHODONTICS, DENTAL PRACTICE OF S. GE

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Previous Names: UPLAND DENTAL AESTHETICS & ORTHODONTICS

Address of Record

121 W. FOOTHILL BOULEVARD, STE. E
UPLAND CA 91786
SAN BERNARDINO county
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Practice Location

121 W. FOOTHILL BOULEVARD, STE. E
UPLAND CA 91786
SAN BERNARDINO county
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Issuance Date

June 10, 2013

Expiration Date

August 31, 2022

Current Date / Time

December 13, 2025
7:53:29 AM

License Relationships

FNP to DDS or OMS

License/Registration Role: Fictitious Name Permit

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

Name: GEWAID, SHENOUDA FATHY

License/Registration Type: Dentist License

License Number: 49753 Primary Status: Current - Active

Address :
470 N 3rd Ave
UPLAND CA 91786-4703
SAN BERNARDINO COUNTY

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