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Licensing details for: 11961

Name: BLUE OAK DENTAL ROSEVILLE, A DENTAL OFFICE OF ARENA GADE WILKES M

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

15 SIERRA GATE PLAZA
ROSEVILLE CA 95678
PLACER county
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Issuance Date

March 30, 2015

Expiration Date

April 30, 2026

Current Date / Time

June 7, 2025
10:3:12 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: ARENA, MARK EDWARD

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: MCCLURE, JEFFREY SCOTT

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: WILKES, ALLEN RANDEL

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: ARENA, MARK EDWARD

License/Registration Type: Dentist License

License Number: 31559 Primary Status: Current - Active

Address :
5410 PARK DRIVE
ROCKLIN CA 95765
PLACER COUNTY

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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: WILKES, ALLEN RANDEL

License/Registration Type: Dentist License

License Number: 30985 Primary Status: Current - Active

Address :
15 Sierra Gate Plz
ROSEVILLE CA 95678-6602
PLACER COUNTY

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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: MCCLURE, JEFFREY SCOTT

License/Registration Type: Dentist License

License Number: 43818 Primary Status: Current - Active

Address :
15 Sierra Gate Plz
ROSEVILLE CA 95678-6602
PLACER COUNTY

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