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Licensing details for: 13786

Name: HIGH DESERT SMILES DENTISTRY DENTAL GROUP, RITESH KUMAR DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

12821 MAIN ST STE 150
HESPERIA CA 92345
SAN BERNARDINO county
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Practice Location

12821 MAIN ST STE 150
HESPERIA CA 92345
SAN BERNARDINO county
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Issuance Date

September 28, 2017

Expiration Date

November 30, 2020

Current Date / Time

June 6, 2025
2:3:32 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: STROMBERG, LOUIS ZANE

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: MOORE, ANDREA CHRISTIANE

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KUMAR, RITESH

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: CHOKKA, SUDHAKAR RAO

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: MOORE, ANDREA CHRISTIANE

License/Registration Type: Dentist License

License Number: 48337 Primary Status: Current - Active

Address :
1875 N Campus Ave
UPLAND CA 91784-8208
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: STROMBERG, LOUIS ZANE

License/Registration Type: Dentist License

License Number: 30879 Primary Status: Expired

Address :
16868 MAIN STREET
HESPERIA CA 92345
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: CHOKKA, SUDHAKAR RAO

License/Registration Type: Dentist License

License Number: 41376 Primary Status: Current - Active

Address :
27949 Greenspot Rd
Ste. H
HIGHLAND CA 92346-4443
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: KUMAR, RITESH

License/Registration Type: Dentist License

License Number: 50944 Primary Status: Current - Active

Address :
2468 San Antonio Cres E
UPLAND CA 91784-1180
SAN BERNARDINO COUNTY

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