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Licensing details for: 10818

Name: PARKER DENTISTRY, DENTAL GROUP OF LINCOLN PARKER, DMD, A PROFESSI

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: PARKER DENTISTRY DENTAL GROUP OF LINCOLN PARKER, DMD, A PROFESSIONAL DENTAL CORP.

Address of Record

777 CORPORATE DRIVE SUITE 100
LADERA RANCH CA 92694
ORANGE county
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Practice Location

777 CORPORATE DRIVE SUITE 100
LADERA RANCH CA 92694
ORANGE county
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Issuance Date

October 9, 2013

Expiration Date

August 31, 2019

Current Date / Time

December 15, 2025
10:43:2 PM

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: PARKER, LINCOLN CHARLES

License/Registration Type: Dentist License

License Number: 61389 Primary Status: Current - Active

Address :
777 Corporate Dr
SUITE 100
LADERA RANCH CA 92694-2135
ORANGE COUNTY

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