Dental Board of California
Licensing details for: 12197
Name: MUIRLANDS DENTAL OFFICE CARLOS E VERLARDE DDS INC
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: MUIRLANDS DENTAL ❖ MUIRLANDS DENTAL, CARLOS E VELARDE DDS INC
Address of Record
23361 EL TORO ROAD, #105
LAKE FOREST CA 92630
ORANGE county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: VELARDE, CARLOS ENRIQUE
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: TASSARA, GIANCARLO GIUSEPPE
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: TASSARA, GIANCARLO GIUSEPPE
License/Registration Type: Dentist License
License Number: 56932 Primary Status: Current - Active
Address :
1111 W Town and Country Rd
Unit 46
ORANGE CA 92868-4615
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: VELARDE, CARLOS ENRIQUE
License/Registration Type: Dentist License
License Number: 53737 Primary Status: Current - Active
Address :
27886 VIOLET
MISSION VIEJO CA 92691
ORANGE COUNTY
