Dental Board of California
Licensing details for: 1056
Name: DR BERKE'S GOLDEN AGE DENTAL CARE
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Previous Names: DR BERKE'S GOLDEN AGE DENTAL CARE DENT PRACT
Address of Record
DENTAL PRACTICE
701 S. RAYMOND AVENUE, STE. 4B
FULLERTON CA 92631
ORANGE county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: BERKE, SAMUEL D
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: STEELE, MARK RICHARD
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: KHZOUZ, ROBERT
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: BERKE, SAMUEL DAVID
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: AGUILAR, SERGIO RICARDO
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SUSMAN, ARNOLD
Address Not Disclosed
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: BERKE, SAMUEL DAVID
License/Registration Type: Dentist License
License Number: 26255 Primary Status: Expired
Address :
2705 BUNGALOW PLACE
CORONA DEL MAR CA 92625
ORANGE COUNTY
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: KHZOUZ, ROBERT
License/Registration Type: Dentist License
License Number: 38700 Primary Status: Current - Active
Address :
10180 Marchant Ave
TUSTIN CA 92782-1450
ORANGE COUNTY
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: AGUILAR, SERGIO RICARDO
License/Registration Type: Dentist License
License Number: 36881 Primary Status: Current - Active
Address :
520 N MAIN ST
STE 120
SANTA ANA CA 92701
ORANGE COUNTY
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: SUSMAN, ARNOLD
License/Registration Type: Dentist License
License Number: 12625 Primary Status: Cancelled
Address :
1505 BARRY AVE.
#101
LOS ANGELES CA 90025
LOS ANGELES COUNTY
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: STEELE, MARK RICHARD
License/Registration Type: Dentist License
License Number: 35031 Primary Status: Current - Active
Address :
9227 ORCO PKWY
STE G
RIVERSIDE CA 92509
RIVERSIDE COUNTY
