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Licensing details for: 13667

Name: SMILELIFE DENTAL GROUP, PRACTICE OF AYALA ANZMENDI DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

1310 W STEWART DR STE 501
ORANGE CA 92868
ORANGE county
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Practice Location

1310 W STEWART DR STE 501
ORANGE CA 92868
ORANGE county
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Issuance Date

August 2, 2017

Expiration Date

August 31, 2024

Current Date / Time

June 6, 2025
2:11:58 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: AYALA ARIZMENDI, MARCELA DOLORES

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: AYALA ARIZMENDI, MARCELA DOLORES

License/Registration Type: Dentist License

License Number: 61047 Primary Status: Current - Active

Address :
1310 W Stewart Dr Ste 501
ORANGE CA 92868-3856
ORANGE COUNTY

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