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Licensing details for: 13853

Name: EAST MURIETA DENTAL GROUP, WATANABE AND ESPELETA PROFESSIONAL DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

39209 WINCHESTER RD STE 100
MURRIETA CA 92563
RIVERSIDE county
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Practice Location

39209 WINCHESTER RD STE 100
MURRIETA CA 92563
RIVERSIDE county
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Issuance Date

November 3, 2017

Expiration Date

July 31, 2018

Current Date / Time

June 6, 2025
2:16:26 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: WATANABE, BRYAN KAZUMI

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: DHAMA, DEEPIKA S

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: ESPELETA, EDWIN REMULLA

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: LEE, FREDERICK HYUN WOO

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: LEE, FREDERICK HYUN WOO

License/Registration Type: Dentist License

License Number: 43359 Primary Status: Current - Active

Address :
4000 W. FLORIDA AVE.
HEMET CA 92545
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: DHAMA, DEEPIKA S

License/Registration Type: Dentist License

License Number: 49044 Primary Status: Current - Active

Address :
2044 California Ave
CORONA CA 92881-3300
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: WATANABE, BRYAN KAZUMI

License/Registration Type: Dentist License

License Number: 40130 Primary Status: Current - Active

Address :
40760 California Oaks Rd.
MURRIETA CA 92562
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: ESPELETA, EDWIN REMULLA

License/Registration Type: Dentist License

License Number: 48105 Primary Status: Current - Active

Address :
39209 WINCHESTER RD STE 100
MURRIETA CA 92563
RIVERSIDE COUNTY

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