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Licensing details for: 11734

Name: WOODLAND SMILES DENTISTRY AND ORTHODONTICS DENTAL GROUP, GILL AND

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

2041 Bronze Star Dr Ste 100
WOODLAND CA 95776-5428
YOLO county
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Practice Location

2041 BRONZE STAR DR
SUITE 100
WOODLAND CA 95776
YOLO county
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Issuance Date

December 5, 2014

Expiration Date

June 30, 2018

Current Date / Time

December 13, 2025
7:54:14 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: GHAZAL, CAROLYN G

License/Registration Type: Dentist License

License Number: 38682 Primary Status: Current - Active

Address :
10797 FOOTHILL BLVD
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY

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