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Licensing details for: 13769

Name: SIMI VALLLEY SMILES DENTAL GROUP, KATAYOUN SETAREH DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

2650 TAPO CANYON RD STE 107
SIMI VALLEY CA 93063
VENTURA county
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Practice Location

2650 TAPO CANYON RD STE 107
SIMI VALLEY CA 93063
VENTURA county
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Issuance Date

September 27, 2017

Expiration Date

June 30, 2018

Current Date / Time

June 6, 2025
2:17:22 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: ELIE, ARASH

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: GHAZAL, CAROLYN G

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: REAGAN, DARIN SCOTT

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: SETAREH, KATAYOUN

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: REAGAN, DARIN SCOTT

License/Registration Type: Dentist License

License Number: 34407 Primary Status: Current - Active

Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE 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: 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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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: SETAREH, KATAYOUN

License/Registration Type: Dentist License

License Number: 50822 Primary Status: Current - Active

Address :
18519 Devonshire St
NORTHRIDGE CA 91324-1308

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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: ELIE, ARASH

License/Registration Type: Dentist License

License Number: 47470 Primary Status: Current - Active

Address :
15740 GREENLEAF STREET
ENCINO CA 91436
LOS ANGELES COUNTY

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