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Licensing details for: 13685

Name: DELMAR DENTAL GROUP, OFFICE OF DR. KHALED EISSA & DR. HASSAN DAOUD

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

1010 E VISTA WAY
VISTA CA 92084
SAN DIEGO county
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Practice Location

1010 E VISTA WAY
VISTA CA 92084
SAN DIEGO county
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Issuance Date

August 11, 2017

Expiration Date

September 30, 2019

Current Date / Time

June 6, 2025
2:10:43 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: DAOUD, HASAN A

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: EISSA, KHALED

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: EISSA, KHALED

License/Registration Type: Dentist License

License Number: 59237 Primary Status: Current - Active

Address :
38157 Hampton Ct
MURRIETA CA 92563-0303
RIVERSIDE 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: DAOUD, HASAN A

License/Registration Type: Dentist License

License Number: 59297 Primary Status: Current - Active

Address :
11968 Bernardo Plaza Dr
SAN DIEGO CA 92128-2538
SAN DIEGO COUNTY

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